Antimicrobial stewardship interventions accepted equally regardless of intervener’s gender

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The authors report no relevant financial disclosures.

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Key takeaways:

• There was no difference in the antimicrobial stewardship intervention acceptance rate based on the gender of the intervening clinician.
• Female patients accepted more interventions than male patients.

Antimicrobial stewardship interventions recommended by either female or male clinicians were equally accepted, according to a recent study.

“Recent publications have reported disparity of antimicrobial stewardship (AS) intervention acceptance dependent on gender of participants in the process,” Sara E Ausman, PharmD, antimicrobial stewardship pharmacist at the Mayo Clinic Health System, told Healio.

Ausman SE, et al. Infect Control Hosp Epidemic. 2023;doi:10.1017/ice.2023.93.

“We were interested in exploring the potential impact of gender on AS intervention acceptance in our large, well-established AS program,” Ausman said.

To assess whether the gender of clinicians making AS recommendations has an impact on intervention acceptance rate, Ausman and colleagues conducted a retrospective, multivariable analysis at a multisite health care system and hospital sites where prospective audit and feedback is performed.

The study included 143 Mayo Clinic clinicians — 84 women and 59 men — whose outcomes were analyzed between July 1, 2017, and June 30, 2022, for intervention rates, communication methods, and intervention acceptance by clinician gender, profession, patient age and ICU status of patient.

In total, 81,927 rules were reviewed by 143 staff members and trainees who worked primarily as pharmacists (n = 104) and physicians (n ​​= 35). Of 71,729 rules meeting study inclusion, 18,175 rules (25%) were associated with an intervention, of which 30% were reviewed by a woman and 18.7% by a man.

Sara E Ausman

Of 10,363 interventions with an outcome documented and assessed, 8,829 (85.2%) were accepted, whereas the remaining 1,534 (14.8%) were rejected. According to the study, there was no significant difference in the acceptance rate between the intervening clinician’s gender.

Female clinicians had 6,782 (86.5%) of 7,843 interventions accepted, whereas male clinicians had 2,047 (81.2%) of 2,520 interventions accepted (P = .19). There was also no difference in the staff profession as it related to recommendation acceptance, with the pharmacist acceptance rate being 85.5% and the physician acceptance rate being 82.3%.

The researchers did, however, determine that there was a statistically significant difference according to patient gender, with female patients having a higher percentage of interventions accepted than male patients (25.9% vs. 24.9%; OR = 1.04; 95% CI, 1.02- 1.08), whereas the rate of intervention acceptance between ICU and non-ICU patients was similar (25.4% vs. 25.1%; OR = 1.11; 95% CI, 0.95-1.29).

“Our data found equal effectiveness in completing antimicrobial stewardship interventions by male and female clinicians,” Ausman said. “Our data [were] limited in that we do not know the gender of the clinicians accepting AS recommendations or how that might impact intervention acceptance.”

She added, “We are optimistic that this signals a decrease in gender bias among health care workers.”

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