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[Evaluation and utilization patterns of antibiotic therapy. A study in 4 hospital departments]
P Massari1, P Czernichow, C Manouvrier
1Département de l'Information Médicale, Centre Hospitalier Universitaire, Rouen.
Abstract:
The use of antibiotics in 480 cases in 4 hospital wards during 1988 was assessed by examination of medical records. Only the first antibiotic therapy administered during the first stay in the ward for each patient was included. Antibiotics were administered to 163 in-patients (37% of hospitalizations) for infections in 113 (26%) cases. Amoxycillin and macrolides were the drugs most frequently used. Sixty-eight percent of the treatments were administered in the absence of microbiological data. Single drug therapy was used in 60% of treatments. Fifty in-patients (11% overall; 41% of patients undergoing surgery) received antibiotics for prophylaxis. The exact indication(s) for the choice of therapy was not given in the medical records of 39% of cases. Treatment started within 48 hours of infection in 15% of the cases. Overall, 93% of the treatments given were indicated, but 53% were inappropriate because they were too expensive, unlikely to be effective or were multiple drug therapy without justification. There are a variety of factors that cause such inappropriate administration of antibiotics.
Insights
Antibiotic use in hospitals was evaluated, revealing that while most treatments were indicated, over half were inappropriate due to cost, efficacy, or unjustified multiple drug therapy. This highlights issues in antibiotic administration practices.
Area of Science:
- Clinical Pharmacy
- Infectious Diseases
- Hospital Administration
Background:
- Antibiotic stewardship is crucial for patient outcomes and combating antimicrobial resistance.
- Inappropriate antibiotic use contributes to increased healthcare costs and the development of resistant pathogens.
- Understanding prescribing patterns is essential for improving antibiotic utilization in hospital settings.
Purpose of the Study:
- To assess the patterns and appropriateness of antibiotic use in four hospital wards in 1988.
- To identify factors contributing to inappropriate antibiotic administration.
- To evaluate the indications and selection of antibiotic therapies.
Main Methods:
- Retrospective review of medical records for 480 cases across four hospital wards.
- Inclusion of only the first antibiotic therapy during a patient's initial ward stay.
- Analysis of antibiotic administration, indications, microbiological data, and treatment duration.
Main Results:
- Antibiotics were administered in 37% of hospitalizations (163 patients), with amoxicillin and macrolides being most frequent.
- 68% of treatments lacked microbiological data; 41% of surgical patients received prophylactic antibiotics.
- While 93% of treatments were indicated, 53% were deemed inappropriate due to cost, efficacy concerns, or unjustified polytherapy.
Conclusions:
- Significant inappropriate antibiotic administration was observed, driven by various factors.
- There is a need for improved antibiotic stewardship programs to optimize therapy selection and reduce unnecessary costs and resistance.
- Further research into prescribing practices and their impact on patient outcomes is warranted.