Poor compliance with an antibiotic directive-A call for intensified monitoring.
Antibiotic stewardship
Antibiotic usage
Electronic monitoring
Journal
International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
ISSN: 1878-3511
Titre abrégé: Int J Infect Dis
Pays: Canada
ID NLM: 9610933
Informations de publication
Date de publication:
Mar 2021
Mar 2021
Historique:
received:
26
11
2020
revised:
11
01
2021
accepted:
13
01
2021
pubmed:
20
1
2021
medline:
23
4
2021
entrez:
19
1
2021
Statut:
ppublish
Résumé
In April 2017, the Central Denmark Region Antibiotic Stewardship Committee issued a directive to reduce the general use of piperacillin-tazobactam and prescribe narrow-spectrum antibiotics for mild and moderate pneumonia. The directive was distributed to all regional hospital clinicians. Electronic medical records were used to obtain de-identified details of all antibiotics administered (together with diagnosis codes) to all in-hospital patients (pre-directive and post-directive) in the nine regional hospitals. Average moving range statistical process control charts were used to analyze pre-directive and post-directive variation in antibiotic usage patterns. Upon the distribution of the directive, a period of decline of the overall usage of piperacillin-tazobactam ensued. Rather than benzylpenicillin, as recommended for pneumonia, the initial decline in piperacillin/tazobactam usage was accompanied by increased use of cefuroxime. A steward-directed reduction in piperacillin-tazobactam usage was accompanied by less desirable usage of a broad-spectrum alternative. Future antibiotic stewardship initiatives will hopefully benefit from close monitoring and timely feedback to clinicians. A dialogue with clinicians based on near real-time data is predicted to improve antibiotic stewardship actions.
Sections du résumé
BACKGROUND
BACKGROUND
In April 2017, the Central Denmark Region Antibiotic Stewardship Committee issued a directive to reduce the general use of piperacillin-tazobactam and prescribe narrow-spectrum antibiotics for mild and moderate pneumonia. The directive was distributed to all regional hospital clinicians.
METHODS
METHODS
Electronic medical records were used to obtain de-identified details of all antibiotics administered (together with diagnosis codes) to all in-hospital patients (pre-directive and post-directive) in the nine regional hospitals. Average moving range statistical process control charts were used to analyze pre-directive and post-directive variation in antibiotic usage patterns.
RESULTS
RESULTS
Upon the distribution of the directive, a period of decline of the overall usage of piperacillin-tazobactam ensued. Rather than benzylpenicillin, as recommended for pneumonia, the initial decline in piperacillin/tazobactam usage was accompanied by increased use of cefuroxime.
CONCLUSIONS
CONCLUSIONS
A steward-directed reduction in piperacillin-tazobactam usage was accompanied by less desirable usage of a broad-spectrum alternative. Future antibiotic stewardship initiatives will hopefully benefit from close monitoring and timely feedback to clinicians. A dialogue with clinicians based on near real-time data is predicted to improve antibiotic stewardship actions.
Identifiants
pubmed: 33465487
pii: S1201-9712(21)00039-4
doi: 10.1016/j.ijid.2021.01.029
pii:
doi:
Substances chimiques
Anti-Bacterial Agents
0
Piperacillin, Tazobactam Drug Combination
157044-21-8
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
474-478Informations de copyright
Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.