The Use of Mobile Educational Tools to Improve Antimicrobial Prescription for the Treatment of Acute Pyelonephritis in Pregnancy: A Retrospective Cross-sectional Study

Abstract

Objective To analyze the prescription of antimicrobial agents for pregnant women admitted into the obstetrics service who presented with acute pyelonephritis. Methods Three cross-sectional studies were performed comparing the prescription of antimicrobials for pyelonephritis in pregnant women in the time periods evaluated (2010-2011: 99 patients evaluated; 2013: 116 patients evaluated; 2015: 107 patients evaluated), at the Hospital Fêmina, Porto Alegre, in the state of Rio Grande do Sul, Brazil. The analysis was performed before and after the promotion of an institutional protocol for the treatment of pyelonephritis during pregnancy, and on a third occasion after the introduction of a smartphone-based mobile educational tool. Results The evaluation of the prescribing physicians and the adequacy of the prescriptions between the different periods studied revealed a significant increase in appropriate conduct for the choice of antimicrobial (2010: 83.8%; 2013: 95.7%; and 2015: 100%), route of administration (2010: 97%; 2013: 100%; and 2015: 100%), and interval (2010: 91.9%; 2013:Vicente Sperb Antonello's ORCID is https://orcid.org/0000-0002-4977-3819.

Use of stewardship smartphone applications by physicians and prescribing of antimicrobials in hospitals: A systematic review

“…app dissemination and use, impact of app use and user experience. Overall, methodological study quality was considered low to moderate for the before-after, interrupted time series and cross-sectional studies [25][26][27][28][29][30][31][32][33][34][35] and moderate to high for qualitative studies [30,35,36] (S4 Text). In most studies participants and outcome assessors were not blinded.…”

“…Four studies analysed whether empirical prescribing of antimicrobials was according to guidelines, such as choice of drug, dose, interval and route of administration [25,31,34,37]. (Table 4) The study of Charani et al in which all antimicrobial guidelines were implemented in the app reported a significant increase in adherence to guidelines in surgical wards and a non-significant increase in general medicine wards [37].…”

“…twelve months. Two studies [25,31] reported an significant increase in adherence to guidelines for pyelonephritis and uncomplicated diarrheal diseases respectively during the intervention period. One study [34] showed increased adherence to the community-acquired pneumonia guideline in one hospital, but not in the other.…”