Who listens and who doesn’t? Factors associated with adherence to antibiotic stewardship intervention in a Singaporean tertiary hospital
Autor: | Yi Xin Liew, Pei Zhi Benjamin Cherng, Maciej Piotr Chlebicki, Lun Yi Tan, Shimin Jasmine Chung, Lay Hoon Andrea Kwa, Si Lin Sarah Tang, Liang En Wee |
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Rok vydání: | 2020 |
Předmět: |
0301 basic medicine
Microbiology (medical) medicine.medical_specialty Multivariate analysis 030106 microbiology Immunology Psychological intervention Logistic regression Microbiology Odds Tertiary Care Centers Antimicrobial Stewardship 03 medical and health sciences 0302 clinical medicine Intervention (counseling) Humans Immunology and Allergy Medicine 030212 general & internal medicine Interventions Retrospective Studies Antibiotic stewardship Singapore business.industry Retrospective cohort study Odds ratio QR1-502 Carbapenems Adherence Family medicine Antibiotic Stewardship business Compliance |
Zdroj: | Journal of Global Antimicrobial Resistance, Vol 22, Iss, Pp 391-397 (2020) |
ISSN: | 2213-7165 |
Popis: | Introduction Antibiotic stewardship programmes (ASPs) can improve patient outcomes by prospective audit and feedback with interventions. However, adherence to ASP interventions is not mandatory. Identifying factors associated with improved adherence may help to enhance ASP recommendations and activities. Methods A retrospective cohort study was conducted, comprising all ASP interventions performed as part of the prospective audit and feedback strategy in our institution (an acute tertiary-care hospital in Singapore) from January 2016 to July 2018. Adherence to ASP intervention was ascertained based on documented compliance with the recommended interventions within 48 h. Factors associated with adherence to ASP interventions, such as patient demographics, clinical condition, type of infection, and characteristics of ASP interventions were identified using the χ2 test for categorical variables. On multivariate analysis, factors independently associated with adherence to ASP intervention were identified using logistic regression. Results Adherence to ASP intervention was 81.9% (5758/7028). On univariate and multivariate analysis, interventions coupled with direct communication via phone call (adjusted odds ratio [aOR] 1.61, 95% CI 1.23–2.08) were associated with higher odds of adherence, whereas admission to a surgical unit, intervention involving carbapenem use, and recommendation to de-escalate or discontinue antibiotics were associated with lower odds of adherence to ASP interventions. Conclusion Although adherence rates to ASP interventions were relatively high, interventions made to the surgical unit and recommendations related to carbapenem use were not so well received. Interventions communicated verbally via phone call were well received, highlighting the need for a close working relationship between ASP teams and hospital physicians. |
Databáze: | OpenAIRE |
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