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Schneider, F.; Schulz, C. M.; May, M.; Pawlik, M.; Hübler, M.; Soukup, J.; Ernst, C.; Schneider, G.; Jacob, M.; Brettner, F.; Kees, M. G.; Graf, B.; Kretzschmar, M.; Hachenberg, T.; Schmidt, M.; Koch, C.; Sander, M.; Zoller, M.; Koch, T.; Brookman-May, S.; Heim, M.; Badelt, Gregor; Boeden, Gerhard; Burger, Maximilian; Eife, Claudia; Forst, Helmuth; de Abreu, Marcello Gama; Freitag, Adrian; Glueckstein, Christa; Karl, Thomas; Müller, Simon; Mutlak, Haitham; Rahmel, Melanie; Schön, Julika; Schöniger, Stephan-Andreas; Stierstorfer, Franz; Zacharowski, Kai; Zwissler, Bernhard (2019): The influence of hospital characteristics on anaesthetists' self-confidence and knowledge about rational antibiotic application - a survey study comparing university and non-university hospitals. In: Anasthesiologie & Intensivmedizin, Vol. 60: pp. 468-478
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Background: treatment in a university hospital has been linked to less adverse events, whereas non-university hospitals have been reported to provide better resident training. We aimed to investigate whether there are differences between university and non-university hospitals in anaesthetists' self-confidence, self-rated knowledge or objective knowledge about the rational application of antibiotics. Methods: The Multi-institutional Reconnaissance of Practice with Multiresistant Bacteria (MR2) questionnaire was administered to 1,268 anaesthetists of seven university, one primary, six secondary and two tertiary care hospitals (n=16) in 2017. It evaluates self-confidence in practical use of antibiotics (1=very unconfident, 4 = very confident, n = 6), self-rated theoretical knowledge (1 =no knowledge, 4 =full knowledge, n=16), and objective knowledge (multiple choice, n=5). Chi-square, Kruskal-Wallis-H tests and logistic regression models (MLRM) were computed to evaluate differences between the physicians from university and non-university hospitals. Results: 684 questionnaires were included (return rate 53,9%), 414 of which (60.5%) were completed by university physicians. The overall self-confidence rate was higher in non-university (mean =2.6 +/- 0.52) than in university (mean= 2.5 +/- 0.52) anaesthetists (p = 0.014). Additionally, non-university physicians (mean=2.6 +/- 0.53) rated their knowledge on antibiotic application higher than university physicians (mean 2.5 +/- 0.46;p=0.008). The overall comparison of correct answers in the objective knowledge items did not reveal any differences between university and non-university physicians. Conclusion: Non-university anaesthesiologists and residents showed higher self-confidence and tended to rate their knowledge higher than university physicians. However, the groups did not differ in their objective knowledge.