Antibiotic prescription practices and their relationship to outcome in South Africa: Findings of the prevalence of infection in South African intensive care units (PISA) study

Paruk, Fathima; Richards, Guy A.; Scribante, Juan; Bhagwanjee, Satish; Mer, Mervyn; Perrie, Helen

doi:10.7196/samj.5833

Cited by 52 publications

(60 citation statements)

References 8 publications

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“…Although some people might question the applicability of our findings to the public sector where most of the population in South Africa receive health care, we would contend that, despite insufficient infectious diseases expertise, this model could be valuable in view of the similar documented overprescribing practices. 9 Successful implementation of the model would require commitment from organisational leadership and tailoring of systems and resources to support the key role of pharmacists in the monitoring, implementation, and feedback process. The crucial role of the development and use of a range of behavioural and improvement science skills beyond those of infectious diseases and microbiology 16; 19 ; 20 cannot be underestimated if sustainable success is to be achieved.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Antimicrobial stewardship across 47 South African hospitals: an implementation study

Brink

Messina

Feldman

et al. 2016

The Lancet Infectious Diseases

176

194

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Section: Discussionmentioning

confidence: 99%

“…9 The quality improvement director and local experts defined the measures according to local and international guidelines and best practice adapted to the South Africa setting (panel 1). 9; 12 ; 13 For all interventions, pharmacists consulted the doctor before changes were made.…”

Section: Antimicrobial Stewardship Interventionsmentioning

confidence: 99%

Antimicrobial stewardship across 47 South African hospitals: an implementation study

Brink

Messina

Feldman

et al. 2016

The Lancet Infectious Diseases

176

194

View full text Add to dashboard Cite

“…All patients were reported to have excellent premorbid functioning prior to ICU admission, with a median Barthel score of 20 (range [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. The median APACHE II score was 17 (IQR 13-23, range 4-43) with the median ISS in the trauma patients being 21 (IQR 10-34, range 1-59).…”

Section: Resultsmentioning

confidence: 99%

“…There was a short median ICU length of stay (LOS) of 3.0 days (IQR 1.0-6.0 days, range 0-59.0 days). In terms of functional outcome, the median 30-day Barthel score was 20 (range [7][8][9][10][11][12][13][14][15][16][17][18][19][20], reflecting excellent functional status.…”

Section: Resultsmentioning

confidence: 99%

Outcomes 30 days after ICU admission: the 30DOS study

Wise

Vasconcellos

Skinner

et al. 2017

Southern African Journal of Anaesthesia and Analgesia

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Background:The spectrum of illness and long-term outcome of critically ill patients admitted to intensive care units (ICUs) in South Africa remains largely unknown. Objectives: This study was designed to provide data on ICU outcomes and disease burden in public sector ICUs in KwaZuluNatal. The primary objective was to describe 30-day mortality of all patients admitted to participating sites. Secondary objectives included clinical demographics and spectrum of illness amongst these patients, and testing a template to demonstrate feasibility of such data collection. Methods: 30DOS was a multicentre, prospective, observational cohort study conducted over 30 days. An a priori decision was made to report study results separately for adults and paediatric patients. This article reports the results for adult patients. The complete 30-DOS study included 11 ICUs in six hospitals. All adult patients admitted to study ICUs were included. Patients were followed up telephonically by a research assistant. Data on patient demographics, preadmission functional scoring, injury severity scoring, co-morbidities, admission diagnosis/es, organ support, and outcome were collected. Results: A total of 228 adults were included. The majority of admissions (73.7%) occurred on an emergency basis, with 68.4% occurring in the postoperative period. Approximately half were for non-communicable disease (49.6%), followed by trauma (29.0%) and infectious disease (21.5%). There were a total of 59 (25.9%) deaths within the first 30 days after admission. In-ICU mortality was 19.7%. There were 12 (5.3%) in-hospital deaths following discharge and two (0.9%) out-of-hospital deaths. Thirtyday survival was known for 174 (76.3%) admissions with a 33.9% mortality rate. Conclusion: Overall in-ICU mortality was 19.7% with a large trauma burden in a young population. Thirty-day mortality was 33.9%. Information pertaining to patient demographics and spectrum of illness provided novel information to further the understanding of the demand placed on critical care resources within South Africa.

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“…4 Antibiotics are commonly prescribed to critically ill patients throughout the world, although a large percentage of these are inappropriate. Since the antibiotic prescription practices in public and private ICUs in South Africa are unknown, the authors studied these practices to determine their relationship to patient outcomes.…”

Section: Prevalence Of Infection In Icusmentioning

confidence: 99%

Editor's Choice

Niekerk¹

2012

S Afr Med J

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Antibiotic prescription practices and their relationship to outcome in South Africa: Findings of the prevalence of infection in South African intensive care units (PISA) study

Cited by 52 publications

References 8 publications

Antimicrobial stewardship across 47 South African hospitals: an implementation study

Antimicrobial stewardship across 47 South African hospitals: an implementation study

Outcomes 30 days after ICU admission: the 30DOS study

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