Fiche publication
Date publication
novembre 2020
Journal
Scientific reports
Auteurs
Membres identifiés du Cancéropôle Est :
Pr THILLY Nathalie
Tous les auteurs :
Krockow EM, Kurvers RHJM, Herzog SM, Kämmer JE, Hamilton RA, Thilly N, Macheda G, Pulcini C
Lien Pubmed
Résumé
Antibiotic overprescribing is a global challenge contributing to rising levels of antibiotic resistance and mortality. We test a novel approach to antibiotic stewardship. Capitalising on the concept of "wisdom of crowds", which states that a group's collective judgement often outperforms the average individual, we test whether pooling treatment durations recommended by different prescribers can improve antibiotic prescribing. Using international survey data from 787 expert antibiotic prescribers, we run computer simulations to test the performance of the wisdom of crowds by comparing three data aggregation rules across different clinical cases and group sizes. We also identify patterns of prescribing bias in recommendations about antibiotic treatment durations to quantify current levels of overprescribing. Our results suggest that pooling the treatment recommendations (using the median) could improve guideline compliance in groups of three or more prescribers. Implications for antibiotic stewardship and the general improvement of medical decision making are discussed. Clinical applicability is likely to be greatest in the context of hospital ward rounds and larger, multidisciplinary team meetings, where complex patient cases are discussed and existing guidelines provide limited guidance.
Référence
Sci Rep. 2020 Nov 2;10(1):18782
