Inappropriateness of Intravenous Antibiotic Prescriptions at Hospital Discharge at a Tertiary Care hospital in Thailand.
antimicrobial stewardship
outpatient parenteral antimicrobial therapy
parenteral antimicrobials
Journal
Drug, healthcare and patient safety
ISSN: 1179-1365
Titre abrégé: Drug Healthc Patient Saf
Pays: New Zealand
ID NLM: 101544775
Informations de publication
Date de publication:
2019
2019
Historique:
received:
03
07
2019
accepted:
30
11
2019
entrez:
8
1
2020
pubmed:
8
1
2020
medline:
8
1
2020
Statut:
epublish
Résumé
Intravenous antibiotics, either as outpatient parenteral antimicrobial therapy (OPAT) or transition of care to community-based management, is a common practice in tertiary care hospitals to minimize hospital stays. However, infectious disease consultation was not mandated for those prescriptions. Therefore, we conducted this study to evaluate the appropriateness of intravenous antibiotic prescriptions at hospital discharge. This retrospective cross-sectional study was conducted among patients receiving care at the internal medicine units of the Maharaj Nakorn Chiang Mai Hospital from November 1, 2015, to April 30, 2016. Intravenous antibiotics at hospital discharge were reviewed by an infectious diseases (ID) specialist. One hundred and twenty-nine prescriptions for 117 patients were reviewed. The most common diagnoses requiring intravenous antibiotics at hospital discharge were upper urinary tract infection (34.2%) and hepatobiliary tract infections (15.4%). The most common intravenous antibiotic was ceftriaxone (36.4%), followed by ertapenem (20.1%). Overall, the inappropriateness of prescriptions was 85.3%. The most common reason for inappropriateness was a failure to switch to oral antibiotics (52.7%), followed by incorrect duration (16.3%). Antimicrobial stewardship should be considered for intravenous antibiotics at hospital discharge to reduce the inappropriateness of those prescriptions.
Sections du résumé
BACKGROUND
BACKGROUND
Intravenous antibiotics, either as outpatient parenteral antimicrobial therapy (OPAT) or transition of care to community-based management, is a common practice in tertiary care hospitals to minimize hospital stays. However, infectious disease consultation was not mandated for those prescriptions. Therefore, we conducted this study to evaluate the appropriateness of intravenous antibiotic prescriptions at hospital discharge.
METHODS
METHODS
This retrospective cross-sectional study was conducted among patients receiving care at the internal medicine units of the Maharaj Nakorn Chiang Mai Hospital from November 1, 2015, to April 30, 2016. Intravenous antibiotics at hospital discharge were reviewed by an infectious diseases (ID) specialist.
RESULTS
RESULTS
One hundred and twenty-nine prescriptions for 117 patients were reviewed. The most common diagnoses requiring intravenous antibiotics at hospital discharge were upper urinary tract infection (34.2%) and hepatobiliary tract infections (15.4%). The most common intravenous antibiotic was ceftriaxone (36.4%), followed by ertapenem (20.1%). Overall, the inappropriateness of prescriptions was 85.3%. The most common reason for inappropriateness was a failure to switch to oral antibiotics (52.7%), followed by incorrect duration (16.3%).
CONCLUSION
CONCLUSIONS
Antimicrobial stewardship should be considered for intravenous antibiotics at hospital discharge to reduce the inappropriateness of those prescriptions.
Identifiants
pubmed: 31908542
doi: 10.2147/DHPS.S221430
pii: 221430
pmc: PMC6929924
doi:
Types de publication
Journal Article
Langues
eng
Pagination
125-129Informations de copyright
© 2019 Mahatumarat et al.
Déclaration de conflit d'intérêts
The authors report no conflicts of interest in this work.
Références
Infect Control Hosp Epidemiol. 2012 Apr;33(4):401-4
pubmed: 22418637
BMC Infect Dis. 2017 Jul 6;17(1):474
pubmed: 28683717
J Hosp Infect. 2007 Oct;67(2):156-60
pubmed: 17881087
J Hosp Med. 2012 May-Jun;7(5):365-9
pubmed: 22315151
J Antimicrob Chemother. 2007 May;59(5):990-5
pubmed: 17387117
J Antimicrob Chemother. 2015 Apr;70(4):965-70
pubmed: 25538169
BMC Infect Dis. 2014 Apr 27;14:226
pubmed: 24767169
Int J Antimicrob Agents. 2014 Jan;43(1):7-16
pubmed: 24200469
Can J Hosp Pharm. 2015 Jul-Aug;68(4):318-26
pubmed: 26327706
Int J Antimicrob Agents. 2005 Dec;26(6):463-72
pubmed: 16280243
Clin Med (Lond). 2013 Oct;13(5):495-9
pubmed: 24115709
BMJ. 2005 Jan 15;330(7483):129
pubmed: 15604157
Am J Med Sci. 2005 Aug;330(2):60-4
pubmed: 16103785
Clin Infect Dis. 2010 Sep 15;51 Suppl 2:S198-208
pubmed: 20731577
J Antimicrob Chemother. 2014 Jun;69(6):1695-700
pubmed: 24532684
Clin Infect Dis. 2004 Jun 15;38(12):1651-72
pubmed: 15227610
Infect Control Hosp Epidemiol. 2006 Apr;27(4):416-20
pubmed: 16622823
J Infect Chemother. 2018 Nov;24(11):915-920
pubmed: 30197092