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Empiric Antibiotic Prescribing Decisions Among Medical Residents: The Role of the Antibiogram

  • Gregory B. Tallman (a1), Rowena A. Vilches-Tran (a1), Miriam R. Elman (a1), David T. Bearden (a1) (a2), Jerusha E. Taylor (a2), Paul N. Gorman (a3) and Jessina C. McGregor (a1)...



To assess general medical residents’ familiarity with antibiograms using a self-administered survey


Cross-sectional, single-center survey


Residents in internal medicine, family medicine, and pediatrics at an academic medical center


Participants were administered an anonymous survey at our institution during regularly scheduled educational conferences between January and May 2012. Questions collected data regarding demographics, professional training; further open-ended questions assessed knowledge and use of antibiograms regarding possible pathogens, antibiotic regimens, and prescribing resources for 2 clinical vignettes; a series of directed, closed-ended questions followed. Bivariate analyses to compare responses between residency programs were performed.


Of 122 surveys distributed, 106 residents (87%) responded; internal medicine residents accounted for 69% of responses. More than 20% of residents could not accurately identify pathogens to target with empiric therapy or select therapy with an appropriate spectrum of activity in response to the clinical vignettes; correct identification of potential pathogens was not associated with selecting appropriate therapy. Only 12% of respondents identified antibiograms as a resource when prescribing empiric antibiotic therapy for scenarios in the vignettes, with most selecting the UpToDate online clinical decision support resource or The Sanford Guide. When directly questioned, 89% reported awareness of institutional antibiograms, but only 70% felt comfortable using them and only 44% knew how to access them.


When selecting empiric antibiotics, many residents are not comfortable using antibiograms as part of treatment decisions. Efforts to improve antibiotic use may benefit from residents being given additional education on both infectious diseases pharmacotherapy and antibiogram utilization.

Infect Control Hosp Epidemiol 2018;39:578–583


Corresponding author

Address correspondence to Gregory B. Tallman, PharmD, MS, 2730 SW Moody Ave, CL5CP, Portland, OR 97201 ( or Jessina C. McGregor, PhD, 2730 SW Moody Ave, CL5CP, Portland, OR 97201 (


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PREVIOUS PRESENTATION. These data were presented in part at the American Society of Health-System Pharmacists 47th Annual Midyear Clinical Meeting on December 3, 2012, in Las Vegas, Nevada.



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1. Centers for Disease Control and Prevention. Core Elements of Hospital Antibiotic Stewardship Programs. Atlanta, GA: US Department of Health and Human Services, CDC; 2014.
2. Barlam, TF, Cosgrove, SE, Abbo, LM, et al. Implementing an antibiotic stewardship program: guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America. Clin Infect Dis 2016;62:e51e77.
3. Kalil, AC, Metersky, ML, Klompas, M, et al. Management of adults with hospital-acquired and ventilator-associated pneumonia: 2016 clinical practice guidelines by the Infectious Diseases Society of America and the American Thoracic Society. Clin Infect Dis 2016;63:e61e111.
4. Solomkin, JS, Mazuski, JE, Bradley, JS, et al. Diagnosis and management of complicated intra‐abdominal infection in adults and children: guidelines by the Surgical Infection Society and the Infectious Diseases Society of America. Clin Infect Dis 2010;50:133164.
5. Abbo, LM, Cosgrove, SE, Pottinger, PS, et al. Medical students’ perceptions and knowledge about antimicrobial stewardship: How are we educating our future prescribers? Clin Infect Dis 2013;57:631638.
6. Giblin, TB, Sinkowitz-Cochran, RL, Harris, PL, et al. Clinicians’ perceptions of the problem of antimicrobial resistance in health care facilities. Arch Intern Med 2004;164:16621668.
7. Mermel, LA, Jefferson, J, Devolve, J. Knowledge and use of cumulative antimicrobial susceptibility data at a university teaching hospital. Clin Infect Dis 2008;46:1789.
8. Evans, CT, Rogers, TJ, Burns, SP, Lopansri, B, Weaver, FM. Knowledge and use of antimicrobial stewardship resources by spinal cord injury providers. PM R 2011;3:619623.
9. Dyar, OJ, Pulcini, C, Howard, P, Nathwani, D, Policies ESGAP (ESCMID Study Group for Antibiotic Policies). European medical students: a first multicentre study of knowledge, attitudes and perceptions of antibiotic prescribing and antibiotic resistance. J Antimicrob Chemother 2014;69:842846.
10. Nori, P, Madaline, T, Munjal, I, et al. Developing interactive antimicrobial stewardship and infection prevention curricula for diverse learners: a tailored approach. Open Forum Infect Dis 2017;4:ofx117.
11. Abbo, L, Sinkowitz-Cochran, R, Smith, L, et al. Faculty and resident physicians’ attitudes, perceptions, and knowledge about antimicrobial use and resistance. Infect Control Hosp Epidemiol 2011;32:714718.

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Empiric Antibiotic Prescribing Decisions Among Medical Residents: The Role of the Antibiogram

  • Gregory B. Tallman (a1), Rowena A. Vilches-Tran (a1), Miriam R. Elman (a1), David T. Bearden (a1) (a2), Jerusha E. Taylor (a2), Paul N. Gorman (a3) and Jessina C. McGregor (a1)...


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