Abstract
Purpose
On January 1st 2019, the new EUCAST definitions of susceptibility testing categories S, I and R took effect. The changes in the I category have considerable clinical impact because they lead to major changes in the antibiogram, and misinterpretation may result in inappropriate selection and dosing of antibiotics hampering effective treatment of infectious diseases. We assessed if German physicians are aware of the new definitions and their consequences.
Methods
We conducted a nationwide web-based survey to assess the knowledge on the new definitions of S, I and R. The survey was addressed to clinicians across all medical specialties working in Germany and was open from May 9th to July 30th 2019.
Results
The answers of 902 participants were included in the analysis. Most participants were employed at hospitals (79.3%) and had already completed specialist training (86.1%). The predominant specialty was internal medicine (50.6%). Of all participants, 45.7% did not know that there was a change in the definitions of S, I and R, and 65.4% did not feel well-informed about the changes. When the participants had to identify true and false statements regarding the new I, substantial knowledge gaps were apparent. Worst results were achieved by those physicians who are not employed in a hospital but work in their own practice.
Conclusion
Our survey shows that German physicians are insufficiently informed about the new definitions of S, I and R. Further education is strongly needed to ensure optimal treatment of infectious diseases.
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Data availability
The original questionnaire and the raw datasets (in German language) are available from the authors on reasonable request.
References
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Acknowledgements
We thank all participants in the survey. Furthermore, we thank the professional societies (namely, German Society of Infectious Diseases, German Society of Internal Medicine, German Society of Anesthesiology and Intensive Care Medicine, German Society of Surgery, German Society of Oto-Rhino-Laryngology, Head and Neck Surgery, German Society for Hygiene and Microbiology and German Society of Hospital Hygiene) and the medical associations (the Ärztekammer of several federal states of Germany and the physicians’ network coliquio) that supported our survey and distributed the weblink to the questionnaire.
Funding
No funding was received for this work.
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Authors and Affiliations
Contributions
RL and NW conceived and designed the study including the questionnaire, and all authors tested and revised the questionnaire. All authors contributed to acquisition, analysis and interpretation of the data. RL drafted the paper, and all authors critically revised the manuscript and approved the final version.
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Competing interests
The authors declare that they have no conflict of interest.
Ethics approval\Consent to participate and for publication
For this survey-based study, ethics approval was not required. Participation in the survey was voluntary, anonymous and without any compensation. By participating, the respondents consented to data storage and processing as well as publication in anonymized and aggregated form. The manuscript does not contain clinical studies or patient data.
Electronic supplementary material
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15010_2020_1456_MOESM1_ESM.pdf
Supplementary file1 In the online resource, the statements used for the knowledge quiz are given, embedded in an educational text on the new definitions of susceptibility testing categories S, I and R. (PDF 198 kb)
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Wantia, N., Gatermann, S.G., Rothe, K. et al. New EUCAST definitions of S, I and R from 2019 – German physicians are largely not aware of the changes. Infection 48, 597–606 (2020). https://doi.org/10.1007/s15010-020-01456-x
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DOI: https://doi.org/10.1007/s15010-020-01456-x