{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T10:29:01Z","timestamp":1766399341645,"version":"build-2065373602"},"reference-count":33,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2023,6,8]],"date-time":"2023-06-08T00:00:00Z","timestamp":1686182400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Consumption of antimicrobials is an important driver of antimicrobial resistance. There is limited knowledge of the key determinants of antimicrobial prescribing behavior in hospitals. An understanding of these determinants is required for the successful design, adoption, and implementation of quality improvement interventions in Antimicrobial Stewardship Programs (ASP). This study aimed to describe the main factors that influence the doctor\u2019s decision on antimicrobials prescribing and to identify the behaviors that drive physicians\u2019 decision making. A structured web-based questionnaire focused on behavioral components of antimicrobial prescription was applied to the medical staff of three different departments\u2014Internal Medicine, General Surgery, and Intensive Care Medicine\u2014of a university hospital. All doctors agreed that inadequate use of antimicrobials increases AMR. A total of 77% of the surgeons and 100% of the internists and intensivists perceived antimicrobial prescription as a priority in the department. Full autonomy in antimicrobial prescription was preferred by internists (64%) but not by surgeons (18%) and intensivists (24%). Most physicians were keen to have ASP advice, but most did not want advice from colleagues of the same service. Almost all surgeons ask for advice when prescribing, but only 68% of the internists do it. Less than half of all physicians and only 25% of the surgeons felt free to prescribe contrary to guidelines. Most physicians, particularly in Intensive Care Medicine (94%), adopt the \u201cwait and see\u201d strategy when no microbiologic confirmation is available, but 27% of the surgeons start empirical therapy. In conclusion, the context of antimicrobial prescription, autonomy, and confidence in antimicrobial prescription demonstrated heterogeneity between the three departments and this should be considered when planning ASP.<\/jats:p>","DOI":"10.3390\/antibiotics12061032","type":"journal-article","created":{"date-parts":[[2023,6,9]],"date-time":"2023-06-09T01:32:34Z","timestamp":1686274354000},"page":"1032","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Behavioral Components and Context of Antimicrobial Prescription in a Tertiary Hospital in Portugal"],"prefix":"10.3390","volume":"12","author":[{"given":"Ana Paula Muniz","family":"Almeida-Costa","sequence":"first","affiliation":[{"name":"Public Health Institute of Porto, 4050-600 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4323-0220","authenticated-orcid":false,"given":"Jos\u00e9-Artur","family":"Paiva","sequence":"additional","affiliation":[{"name":"Intensive Care Medicine Service at Centro Hospitalar Universit\u00e1rio S\u00e3o Jo\u00e3o (CHUSJ), 4200-319 Porto, Portugal"},{"name":"Medicine Department at Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1337-7179","authenticated-orcid":false,"given":"Ant\u00f3nio Jorge Santos","family":"Almeida","sequence":"additional","affiliation":[{"name":"Medicine Department at Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"},{"name":"Internal Medicine Service at Centro Hospitalar Universit\u00e1rio S\u00e3o Jo\u00e3o (CHUSJ), 4200-319 Porto, Portugal"}]},{"given":"Elisabete","family":"Barbosa","sequence":"additional","affiliation":[{"name":"General Surgery Service at Centro Hospitalar Universit\u00e1rio S\u00e3o Jo\u00e3o (CHUSJ), 4200-319 Porto, Portugal"}]},{"given":"Sofia","family":"Correia","sequence":"additional","affiliation":[{"name":"ISPUP-EPIUnit\u2014Instituto de Sa\u00fade P\u00fablica da Universidade do Porto, 4050-600 Porto, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2023,6,8]]},"reference":[{"key":"ref_1","unstructured":"OECD (2023, January 03). 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