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The 56-item self-administered questionnaire collected information on junior doctors�� attitudes about antibiotic prescribing, their perception Tryptophan synthase of the importance of the problem of antibiotic resistance, their knowledge of the national prevalence of antibiotic resistance and local prevalence of antibiotic misuse, their beliefs about the causes of antibiotic resistance, and their attitudes about current and potential interventions designed to improve antibiotic stewardship. Data were also collected about their current specialty, the frequency with which they prescribed antibiotics, and past training in antibiotic prescribing. The questionnaire is included in the Supporting Information section (or is available from C.P.), in both English and French (with identical questions). Most questions about perceptions and attitudes used four-point or five-point Likert-style response options, from very unhelpful/unimportant/unconfident, to very helpful/important/confident. To assess knowledge of the prevalence of antibiotic PI3K inhibitors ic50 resistance, junior doctors were asked to estimate the prevalence of resistance in their country for two specific bacterium�Cantibiotic combinations relevant to clinical practice: Escherichia coli resistance to trimethoprim in Scotland and to fluoroquinolones in France in community-acquired infections, and Staphylococcus aureus resistance to methicillin in hospital-acquired infections in both countries. Rates of resistance in 2005 were obtained from national surveillance systems: the Observatoire National de l��Epid��miologie de la R��sistance Bact��rienne aux Antibiotiques (ONERBA, http://www.onerba.org) for France, and Health Protection Scotland for Scotland (http://www.hps.scot.nhs.uk). Alectinib mw We also assessed knowledge of the local prevalence of antibiotic misuse; recent rates of misuse were obtained from local audits, published in Nice [3,13�C16] and unpublished in Dundee. On the basis of a review of the literature [2,4�C6,17], we selected nine essential steps of an antibiotic prescribing process, seven possible causes of antibiotic resistance and 14 possible interventions for inclusion in the questionnaire. We distributed the questionnaire in November 2007 in Dundee, when the junior doctors had been working for 3?months. The doctors were asked to complete the survey at the beginning of a compulsory training session on sepsis management and prescribing. They had no prior warning of the survey. However, as only 75% or higher attendance at all sessions was required to complete their annual continuing professional requirements, the doctors could choose to be absent from these sessions. In Nice, the questionnaire was sent by E-mail and mail in January 2008, when the junior doctors had been working for 3?months and more, and could be returned by fax, E-mail or mail in the provided envelope. Questionnaires not returned within 3?weeks triggered E-mail and mail reminders.