A multicentre stewardship initiative to decrease excessive duration of antibiotic therapy for the treatment of community-acquired pneumonia
| Autor: | Gregory A. Eschenauer, Vincent D. Marshall, Sara Revolinski, Jerod Nagel, Tejal K. Gandhi, Lindsay Colyer, Twisha S Patel, Julius Li, Angela M. Huang, J Njeri Wainaina, Jessica Grieger, Megan Lim, Cynthia T Nguyen, Farnaz Foolad, Megan Mack |
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| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Microbiology (medical) Adult Male medicine.medical_specialty Emergency Medical Services Adolescent Non-Randomized Controlled Trials as Topic 030106 microbiology Psychological intervention Patient Readmission Time 03 medical and health sciences Antimicrobial Stewardship Young Adult 0302 clinical medicine Community-acquired pneumonia Medicine Humans Pharmacology (medical) 030212 general & internal medicine Young adult Aged Pharmacology Aged 80 and over business.industry Clostridioides difficile Incidence (epidemiology) Health services research Pneumonia Clostridium difficile Middle Aged medicine.disease Survival Analysis Drug Utilization Anti-Bacterial Agents Community-Acquired Infections Infectious Diseases Emergency medicine Clostridium Infections Female Stewardship Health Services Research business |
| Zdroj: | The Journal of antimicrobial chemotherapy. 73(5) |
| ISSN: | 1460-2091 |
| Popis: | Background The increased emphasis on pneumonia-related performance measures and patient outcomes has led hospitals to implement multifaceted approaches to quickly identify patients with community-acquired pneumonia (CAP), start timely therapy and reduce readmission. However, there has been minimal focus on duration of therapy (DOT) and patients often receive prolonged antibiotic courses. The IDSA and American Thoracic Society (IDSA/ATS) CAP guidelines recommend 5 days of therapy for clinically stable patients that quickly defervesce and stewardship teams are well positioned to influence prescribing practices. Objectives Determine the impact of a prospective stewardship intervention on total antibiotic DOT and associated clinical outcomes in hospitalized patients with CAP. Methods This multicentre, quasi-experimental study evaluated three concurrent interventions over a 6 month period to promote appropriate DOT. All centres updated institutional CAP guidelines to promote IDSA/ATS-concordant DOT, provided education and conducted daily audit and feedback with intervention to provide patient-specific DOT recommendations. Results A total of 600 patients with CAP were included (307 in the historical control group and 293 in the stewardship intervention group). The stewardship intervention increased compliance with DOT recommendations (42% versus 5.6%, P |
| Databáze: | OpenAIRE |
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