TY - JOUR
T1 - Potential to reduce antibiotic use in secondary care
T2 - Single-centre process audit of prescription duration using NICE guidance for common infections
AU - Powell, Neil
AU - Stephens, Jennie
AU - Rule, Rory
AU - Phillips, Ryan
AU - Morphew, Megan
AU - Garry, Emma
AU - Askaroff, Natasha
AU - Hiley, Daniel
AU - Strachan, Charlie
AU - Sheehan, Myles
AU - McDonald, Caitlin
N1 - Publisher Copyright:
© 2021 Royal College of Physicians. All rights reserved.
PY - 2021/1
Y1 - 2021/1
N2 - Introduction Antibiotic use drives antibiotic resistance. Reducing antibiotic use through reducing antibiotic course lengths could contribute to the UK national ambition to reduce total antibiotic use. Methods Medical notes were reviewed for patients who had received at least 5 days of antibiotic therapy; had been discharged in January 2019; and were from a 750-bed acute secondary care hospital in England. UK national guidelines were used to determine the excess antibiotic use in common medical infections: community-acquired pneumonia (CAP), hospital-acquired pneumonia (HAP), pyelonephritis, cellulitis, infective exacerbation of chronic obstructive pulmonary disease (IECOPD) and cholangitis. Results Four-hundred and twenty-three patients met the inclusion criteria. Of these, 307 (73%) patient notes were retrieved and reviewed. One-hundred and seventy-three patients met the study case definitions, of which, 137 met short course criteria. Potential antibiotic reductions (measured in defined daily doses) were identified for five of the six infections: 32% in CAP, 20% in HAP, 14% in IECOPD, 11% in cellulitis and 10% in pyelonephritis. These reductions were estimated to reduce total antibiotic use in medical specialties by 12.4%, which equates to 3.6% of the hospital's total antibiotic use. Conclusion Clinical application of the evidence-based guidance for shorter antibiotic course lengths appears to be a valid strategy for reducing total antibiotic consumption.
AB - Introduction Antibiotic use drives antibiotic resistance. Reducing antibiotic use through reducing antibiotic course lengths could contribute to the UK national ambition to reduce total antibiotic use. Methods Medical notes were reviewed for patients who had received at least 5 days of antibiotic therapy; had been discharged in January 2019; and were from a 750-bed acute secondary care hospital in England. UK national guidelines were used to determine the excess antibiotic use in common medical infections: community-acquired pneumonia (CAP), hospital-acquired pneumonia (HAP), pyelonephritis, cellulitis, infective exacerbation of chronic obstructive pulmonary disease (IECOPD) and cholangitis. Results Four-hundred and twenty-three patients met the inclusion criteria. Of these, 307 (73%) patient notes were retrieved and reviewed. One-hundred and seventy-three patients met the study case definitions, of which, 137 met short course criteria. Potential antibiotic reductions (measured in defined daily doses) were identified for five of the six infections: 32% in CAP, 20% in HAP, 14% in IECOPD, 11% in cellulitis and 10% in pyelonephritis. These reductions were estimated to reduce total antibiotic use in medical specialties by 12.4%, which equates to 3.6% of the hospital's total antibiotic use. Conclusion Clinical application of the evidence-based guidance for shorter antibiotic course lengths appears to be a valid strategy for reducing total antibiotic consumption.
KW - Antimicrobial stewardship
KW - NICE clinical guidelines
KW - Optimise antibiotics
KW - Short course lengths
UR - http://www.scopus.com/inward/record.url?scp=85100326326&partnerID=8YFLogxK
U2 - 10.7861/CLINMED.2020-0141
DO - 10.7861/CLINMED.2020-0141
M3 - Article
C2 - 33479082
AN - SCOPUS:85100326326
SN - 1470-2118
VL - 21
SP - E39-E44
JO - Clinical Medicine
JF - Clinical Medicine
IS - 1
ER -