Influence of laboratory sensitivity reporting on antibiotic prescribing preferences of general practitioners in the Leeds area.

Langdale, P; Millar, M R

doi:10.1136/jcp.39.2.233

Cited by 8 publications

(3 citation statements)

References 3 publications

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“…Guiding the clinician using the antibiogram as an AMS tool could reach many more patients in a very cost-effective way. Selective antibiotic reporting is recommended by most AMS guidelines [1-3, 12, 20, 21], although the evidence is very scant: very few studies have proved a signi cant effect on antibiotic consumption for urinary tract infections or infections due to gram-negative pathogens [24][25][26][27][28] or for the use of rifampicin [29]. To our knowledge there are no studies on frequently occurring and often severe S. aureus infections.…”

Section: Discussionmentioning

confidence: 99%

Staphylococcus Aureus: Selective Reporting of Antibiogram Results and Its Impact on Antibiotic Use. Interventional Study with a Reference Group on the Effect of Switching from Non-Selective to Selective Antibiotic Reporting

Lestin-Bernstein¹,

Harberg²,

Schumacher³

et al. 2020

Preprint

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Background:Antimicrobial stewardship (AMS) strategies worldwide focus on optimised antibiotic use. Selective susceptibility reporting is recommended as an effective AMS tool, although there is a lack of representative studies investigating the impact of selective susceptibility reporting on antibiotic use.The aim of this study was to investigate the impact of selective susceptibility reporting of Staphylococcus aureus (S. aureus) on antibiotic consumption. Enhancing the use of narrow-spectrum beta-lactam antibiotics such as flucloxacillin/cefazolin/cefalexin is one of the main goals in optimising antibiotic therapy of S. aureus infections.Methods:This interventional study with control group was conducted at a tertiary care hospital in Germany. During the one-year interventional period, susceptibility reports for all methicillin-sensitive S. aureus (MSSA) were restricted to flucloxacillin/cefazolin/oral cefalexin, trimethoprim-sulfamethoxazole, clindamycin, gentamicin and rifampin/fosfomycin; instead of reporting all tested antibiotics during the year before the intervention and in the reference clinic. The impact of the intervention was analysed by monitoring antibiotic consumption (recommended daily dose/100 occupied bed days: RDD/100 BD).Results:MSSA-antibiograms were reported for 2836 patients. Total use of narrow-spectrum beta-lactams more than doubled during the intervention (from 1.2 to 2.8 RDD/100 BD, P<0.001; P<0.001 compared to the reference clinic); the percentage of total antibiotic use increased from 2.6% to 6.2%. A slight, but significant increase in the use of trimethoprim-sulfamethoxazole was also observed (+ 0.37 RDD/100 BD).There was no decrease in antibiotics withdrawn from the antibiogram, probably as a consequence of their wide use for indications other than S. aureus infections.Conclusions:As narrow-spectrum beta-lactams are not widely used for other infections, there is a strong indication that selective reporting guided clinicians to optimised antibiotic therapy of S. aureus infections.As useful AMS tool, we recommend implementing selective reporting rules into the national/international standards for susceptibility reporting.

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Section: Discussionmentioning

confidence: 99%

Staphylococcus Aureus: Selective Reporting of Antibiogram Results and Its Impact on Antibiotic Use. Interventional Study with a Reference Group on the Effect of Switching from Non-Selective to Selective Antibiotic Reporting

Lestin-Bernstein¹,

Harberg²,

Schumacher³

et al. 2020

Preprint

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“…There are many other measures to improve the quality of antibiotic prescribing and we are investigating some of these; for example, Centralised Intravenous Administration Services (CIVAS) (Cousins et al, 1989), computer links between microbiology and pharmacy (Corkhill et al, 1984), nursing administration of iv drugs (Clark et al, 1986), use of restricted antibiotic sensitivity reporting (Langdale & Millar, 1986), and reporting the cost of antimicrobial agents on bacteriology report forms (Campo & Mylotte, 1988). Since April 1993, each ward has been responsible for the management of its own pharmacy budget through Directorates.…”

Section: Discussionmentioning

confidence: 99%

Trends in hospital antibiotic prescribing after introduction of an antibiotic policy

Gould

Jappy²

1996

Journal of Antimicrobial Chemotherapy

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Trends in antibiotic prescribing in Grampian were monitored prospectively for seven years from 1986 using computerised ward stock lists and laboratory data relating to all in-patient and out-patient treatments in all Grampian hospitals serving a population of 500,000. The main outcome measures were the number of antibiotics available for routine and restricted uses, annual expenditure and defined daily doses (DDDs) of high expenditure antimicrobial agents. An antibiotic committee introduced a policy and formulary in the third year of the study which had only limited success in controlling prescribing. During the period of the study 30 new antibiotics were considered for inclusion in the hospital formulary, but only seven were incorporated, and all for restricted use only. Despite this, expenditure on antibiotics has more than doubled since 1986, two thirds of the increase being due to the use of new drugs. There was also an increased use of older antibiotics (DDDs increased by 33%), often for no clear reasons, and an overall increase of 46% in DDDs. Antibiotics have increased from 11.9-18.7% as a proportion of the drug budget. These findings highlight the current difficulty in controlling prescribing budgets, the increasing use of antibiotics and the consequent spread of resistance.

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“…There is conflicting evidence regarding the link between laboratory antimicrobial susceptibility reporting and antibiotic prescribing pattern 7,8,9 . Due to varied reasons such as long turnover time for generating the AST report, poor communication between the laboratory and physician, morbid condition of the patient the clinician might continue using the empirical antibiotic even after getting an AST report 4,8 .…”

Section: Discussionmentioning

confidence: 99%

To study the prescription practices after the availability of antibiotic sensitivity reports in a tertiary care hospital

Somanna

Aravind

2014

Int Jour of Biomed Res

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Influence of laboratory sensitivity reporting on antibiotic prescribing preferences of general practitioners in the Leeds area.

Cited by 8 publications

References 3 publications

Staphylococcus Aureus: Selective Reporting of Antibiogram Results and Its Impact on Antibiotic Use. Interventional Study with a Reference Group on the Effect of Switching from Non-Selective to Selective Antibiotic Reporting

Staphylococcus Aureus: Selective Reporting of Antibiogram Results and Its Impact on Antibiotic Use. Interventional Study with a Reference Group on the Effect of Switching from Non-Selective to Selective Antibiotic Reporting

Trends in hospital antibiotic prescribing after introduction of an antibiotic policy

To study the prescription practices after the availability of antibiotic sensitivity reports in a tertiary care hospital

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