Assessment of adherence to printed guidelines for antimicrobial drug use in a university hospital

Abstract

Objectives To assess the quality of antimicrobial prescribing and the level of adherence to the guidelines in the department of medicine at a university hospital. Methods A point prevalence survey was conducted between September 2008 and May 2011 at four selected time points. Demographic and relevant clinical patient data for those receiving antibiotic treatment were recorded. The necessity of antimicrobial treatment was assessed according to a scoring system based on the presence of signs and symptoms of an infection. Antibiotic use was judged according to Guidelines for hospital antimicrobial drug use published in December 2008. Results The percentage of patients receiving antimicrobials varied from 30.8% (N=73) (September 2008) to 25.1% (N=60) (May 2011). At the first time point, 37.3% (N=25) of patients received antimicrobial therapy that was not necessary significantly more often than at other time points (p<0.01). Level of adherence to the guidelines varied between 35.0% (April 2009) and 50.0% (May 2011). The highest level of non-compliance with the guidelines was observed when cefuroxime, ceftriaxone and ciprofloxacin were prescribed. Conclusions Our study demonstrates a continuous overuse of broad-spectrum antibiotics. A decrease in unnecessary antibiotic use and an increase in treatments based on susceptibility testing were noted in the periods when the guidelines were in use. This speaks in favour of guidelines for antimicrobial treatment being a valuable part of antimicrobial stewardship programmes.

Impact of clinical pharmacist intervention on antimicrobial use in a small 164-bed hospital

“…The development and distribution of clinical practice guidelines adapted to local needs and adherence to them is essential to prevent the emergence of AMR and to ensure judicious use of antimicrobials,2 yet a multicentre study has shown that 37.8% of antibiotic use in European hospitals does not comply with local guidelines 3. Antibiotic resistance rates vary in Europe, with the highest rates reported for Greece, Portugal, Italy and Spain, where antibiotic consumption is higher than for their northern counterparts 4…”

Evaluating Antibiotic Treatment Guideline Adherence to Ongoing Antibiotic Stewardship in a Tertiary Care Setting: A Retrospective Observational Study

“…Similarly, the incorrect duration was further categorized into insufcient and excessive duration. Te independent variables comprised the following variables: unit/department, gender, age, presence of comorbidities, comorbidities, infectious diseases, antibiotic (drug) allergy, and drug sensitivity test and empiric antibiotics, similar to other studies [31][32][33][34][35][36].…”