Development of national prescribing indicators for antimicrobials to support reduction in Clostridium difficile infection

Sneddon, Jacqueline; Nathwani, Dilip; Patton, Andrea; Malcolm, William; Watson, Emma

doi:10.1016/j.jinf.2011.04.102

Cited by 1 publication

(2 citation statements)

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“…An additional 15 citations were identified from the grey literature search for a total of 123 publications (figure 1). 13–135 Of the 123 studies, 64 were peer reviewed, 53 were conference proceedings and 6 were online documents (eg, reports).…”

Section: Resultsmentioning

confidence: 99%

“…Overall, 52 studies reported the prevalence of indication documentation 13–15 17 19 21 23 26–29 40 45–47 49 53 60 61 65 67 71 72 74 75 78 82 83 87 89 91 92 97 100–102 106 108 109 109 110 112 114 115 117 124–129 135. The median reported prevalence of indication documentation was 75%; however, there was a wide range across studies from 4% to 100% of antimicrobial orders with an indication documented, with an IQR of 51%–85%.…”

Section: Resultsmentioning

confidence: 99%

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Documenting the indication for antimicrobial prescribing: a scoping review

Saini

Leung

et al. 2022

BMJ Qual Saf

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BackgroundDocumenting an indication when prescribing antimicrobials is considered best practice; however, a better understanding of the evidence is needed to support broader implementation of this practice.ObjectivesWe performed a scoping review to evaluate antimicrobial indication documentation as it pertains to its implementation, prevalence, accuracy and impact on clinical and utilisation outcomes in all patient populations.Eligibility criteriaPublished and unpublished literature evaluating the documentation of an indication for antimicrobial prescribing.Sources of evidenceA search was conducted in MEDLINE, Embase, CINAHL and International Pharmaceutical Abstracts in addition to a review of the grey literature.Charting and analysisScreening and extraction was performed by two independent reviewers. Studies were categorised inductively and results were presented descriptively.ResultsWe identified 123 peer-reviewed articles and grey literature documents for inclusion. Most studies took place in a hospital setting (109, 89%). The median prevalence of antimicrobial indication documentation was 75% (range 4%–100%). Studies evaluating the impact of indication documentation on prescribing and patient outcomes most commonly examined appropriateness and identified a benefit to prescribing or patient outcomes in 17 of 19 studies. Qualitative studies evaluating healthcare worker perspectives (n=10) noted the common barriers and facilitators to this practice.ConclusionThere is growing interest in the importance of documenting an indication when prescribing antimicrobials. While antimicrobial indication documentation is not uniformly implemented, several studies have shown that multipronged approaches can be used to improve this practice. Emerging evidence demonstrates that antimicrobial indication documentation is associated with improved prescribing and patient outcomes both in community and hospital settings. But setting-specific and larger trials are needed to provide a more robust evidence base for this practice.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%