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Published on: August 30, 2018

Antimicrobial use in a small rural hospital

A Langdon, P C Shah, D L Webster

    Canadian Family Physician Medecin De Famille Canadien
    |February 1, 2011
    PubMed

    Insights

    Antimicrobial use was audited in a rural Canadian hospital, revealing 33.7% of patients received antibiotics. While appropriate for children, 15% of adult treatments were inappropriate, particularly for skin and urinary tract infections.

    Area of Science:

    • Clinical Pharmacy
    • Infectious Diseases
    • Healthcare Auditing

    Background:

    • Antimicrobial stewardship is crucial for combating resistance and optimizing patient outcomes.
    • Understanding local antimicrobial prescribing patterns is essential for targeted interventions.
    • Rural healthcare settings may present unique challenges in antimicrobial use.

    Purpose of the Study:

    • To audit and characterize the patterns of systemic antimicrobial utilization in a small rural Canadian hospital.
    • To assess the appropriateness of antimicrobial prescribing among hospitalized pediatric and adult patients.
    • To identify specific patient groups and infection types associated with inappropriate antimicrobial use.

    Main Methods:

    • A retrospective audit of 252 hospitalized patients over a three-month period.
    • Data collection included patient demographics, diagnoses, prescribed antimicrobial agents, and treatment duration.
    • Prescribing appropriateness was evaluated based on established clinical guidelines.

    Main Results:

    • 85 patients (33.7%) received systemic antimicrobials, comprising 19 children and 66 adults.
    • Respiratory infections were the most common indication for antimicrobial therapy in both age groups.
    • Ampicillin/amoxicillin was the most frequently prescribed agent; treatment was appropriate in all children but inappropriate in 15% of adults, notably for superficial skin and catheter-associated urinary tract infections.

    Conclusions:

    • Significant antimicrobial use was observed, with a notable rate of inappropriate prescribing in adult patients.
    • Targeted interventions focusing on specific infections and patient populations are needed to improve antimicrobial stewardship.
    • Further investigation into the causes of inappropriate use is warranted to develop effective prevention strategies.

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