Assessing the impact of institution-specific guidelines for antimicrobials on doctors' prescribing behavior at a German tertiary-care center and the additional benefits of providing a mobile application

Objective To assess usage patterns, perceived usability, and effects of institution-specific guidelines (ISGs) for antimicrobials on clinicians' prescribing behavior and the additional benefits of the mobile application (app), a single-center survey among medical doctors was performed. Methods The study was carried out in a 1451-bed tertiary-care academic medical center in Leipzig, Germany. To ensure optimal empirical antibiotic therapies, appropriate diagnostics, and targeted antimicrobial prophylaxis, ISGs were provided as printed pocket guides (since 2014), a PDF version on ward computers, and a mobile app (since 2017). For the survey, we used an electronically structured cross-sectional questionnaire with 31 items, ordinal Likert scales, and percent bars, allowing for quantitative comparisons. Results Of the 914 doctors contacted by email, 282 (31%) responded, and 254 (28%) surveys were eligible. ISGs were reported to be the most commonly used source of information for antimicrobial prescribing among the respondents. Ninety-four percent used ISGs at least once and 55% at least weekly. On average, participants reported using them in 38% of antibiotic prescriptions and to adhere to consulted recommendations in 87% of cases. Young clinicians (