Related Experiment Videos
Survey of antibiotic prescribing in a district general hospital. I. Pattern of use
Abstract:
In a survey of all antibiotic prescription in a district general hospital during November, 1978, the reason for each prescription was determined by a brief interview with the prescriber. 28% of all inpatients received antibiotics. Older patients were prescribed antibiotics more often than were younger patients. Ampicillin was the most frequently used antibiotic, accounting for over 40% of prescriptions. Over 70% of antibiotic courses were stated by the prescriber as being for the treatment of infection and the remainder were said to be prophylactic. Although 80% of the antibiotics were assessed as suitable treatment for the stated infection, most of the patients were treated without bacteriological evidence of the infecting agent and, for these patients, prescribers were unable to specify the pathogen against which treatment was intended in 50% of the courses they initiated. Only 7% of antibiotics prescribed for conventional surgical prophylaxis fulfilled all the criteria used to assess the suitability of choice of drug and the method and timing of its administration.
Insights
Antibiotic use in hospitals is common, especially for older patients. Many prescriptions lacked clear infection evidence or pathogen identification, raising concerns about appropriate antibiotic stewardship.
Area of Science:
- Clinical Pharmacy
- Infectious Diseases
- Hospital Epidemiology
Background:
- Antibiotic prescribing patterns significantly impact patient outcomes and antimicrobial resistance.
- Understanding the rationale behind antibiotic prescriptions is crucial for optimizing their use in healthcare settings.
Purpose of the Study:
- To analyze antibiotic prescription practices and their justifications in a district general hospital.
- To assess the appropriateness of antibiotic use for both treatment and prophylaxis.
Main Methods:
- A survey of all antibiotic prescriptions issued in November 1978.
- Interviews with prescribers to determine the reason for each prescription.
- Assessment of prescription suitability based on stated infection and prophylactic criteria.
Main Results:
- 28% of inpatients received antibiotics; older patients were prescribed them more frequently.
- Ampicillin was the most common antibiotic (over 40% of prescriptions).
- While 80% of treatments were deemed suitable for stated infections, 50% lacked pathogen specificity; only 7% of prophylactic prescriptions met all criteria.
Conclusions:
- Significant antibiotic use occurred, with frequent prescriptions lacking definitive microbiological evidence.
- The study highlights potential areas for improvement in antibiotic stewardship, particularly concerning prophylactic use and pathogen identification.