Aim: To assess the adherence of antibiotic prescribing in emergency departments (ED) to hospital guidelines. Method: A four-week concurrent review was undertaken in the ED of three teaching hospitals. All parenteral antibiotic courses initiated in the ED were classified as adherent to guidelines, non-adherent to guidelines or indeterminate. Courses adhering to guidelines were then divided into four prescriber categories: intern, resident, registrar, or consultant. A prescriber questionnaire was administered in one hospital to determine prescriber access to the Antibiotic Guidelines (Therapeutic Guidelines -9th edition). Results: Of the 273 cases of parenteral antibiotics prescribed, 58 (21%) adhered to the hospital guidelines, 197 (72%) did not adhere and 18 (7%) were classified as indeterminate. After considering local prescribing patterns, the proportion of adherence was still only 54%. There were no significant differences in the proportion of adherence between the four prescriber categories. In the surveyed hospital, 71 % of prescribers had access to the Antibiotic Guidelines 9th edition. Conclusion: There was low adherence to antibiotic guidelines within the ED. Prescriber experience was not a significant influence on this result. Aust J Hosp Pharm 1999; 29: 155-8.
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