Low Levels of Adherence to Antibiotic Prescribing Guidelines within Emergency Departments

Abstract

Aim: To assess the adherence of antibiotic prescribing in emergency departments (ED) to hospital guidelines. Method: A four-week concurrent review was undertaken in the ED of three teaching hospitals. All parenteral antibiotic courses initiated in the ED were classified as adherent to guidelines, non-adherent to guidelines or indeterminate. Courses adhering to guidelines were then divided into four prescriber categories: intern, resident, registrar, or consultant. A prescriber questionnaire was administered in one hospital to determine prescriber access to the Antibiotic Guidelines (Therapeutic Guidelines -9th edition). Results: Of the 273 cases of parenteral antibiotics prescribed, 58 (21%) adhered to the hospital guidelines, 197 (72%) did not adhere and 18 (7%) were classified as indeterminate. After considering local prescribing patterns, the proportion of adherence was still only 54%. There were no significant differences in the proportion of adherence between the four prescriber categories. In the surveyed hospital, 71 % of prescribers had access to the Antibiotic Guidelines 9th edition. Conclusion: There was low adherence to antibiotic guidelines within the ED. Prescriber experience was not a significant influence on this result. Aust J Hosp Pharm 1999; 29: 155-8.

Adherence to guideline‐based antibiotic treatment for acute exacerbations of chronic obstructive pulmonary disease in an Australian tertiary hospital

“…However, past studies involving Australian hospitals demonstrate use of antibiotic regimens that differ from guideline recommendations . It has been postulated that, in the case of AECOPD, initial diagnostic uncertainty or guidelines promoting early use of intravenous (IV) antibiotics in all patients with suspected pneumonia may partly explain inappropriate use of antibiotics.…”

Snapshot of Antimicrobial Stewardship in Australian Hospitals

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