Feasibility study of prospective audit, intervention and feedback as an antimicrobial stewardship strategy at the Lagos University Teaching Hospital
| Autor: | Iretiolu Fajolu, Philip O Oshun, Alero Ann Roberts, C.S. Osuagwu, O.O. Oduyebo, Edamisan Temiye, Opeyemi M Awofeso |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Universities Nigeria Audit 030204 cardiovascular system & hematology 03 medical and health sciences Antimicrobial Stewardship 0302 clinical medicine Antibiotic resistance Intervention (counseling) medicine Antimicrobial stewardship Humans Medical prescription Practice Patterns Physicians' Child Hospitals Teaching Retrospective Studies Medical Audit business.industry Retrospective cohort study General Medicine Antimicrobial Checklist Anti-Bacterial Agents Family medicine Feasibility Studies business Emergency Service Hospital 030217 neurology & neurosurgery |
| Zdroj: | The Nigerian postgraduate medical journal. 27(1) |
| ISSN: | 1117-1936 |
| Popis: | Antimicrobial resistance, a global problem, is mostly a consequence of misuse or overuse of antimicrobials. This study sought to audit the compliance to hospital antimicrobial policy and determine the ability of medical students to carry out audits.This was a retrospective study to determine compliance with departmental policies in the preceding 2 months in the Children's Emergency Room (ChER) using a checklist. The primary outcome was to determine the rational use of antibiotics. The secondary outcomes were to determine whether the de-escalation of antibiotic, change from intravenous to oral or change in prescriptions were performed in line with culture results based on the departmental policy.The records of 450 children who attended ChER of Lagos University Teaching Hospital in January and February 2018 were retrieved for this study, of which 279 (62.0%) were prescribed antimicrobials. A suspected or confirmed diagnosis of infection was made in 214 (76.6%) of the patients, significantly highest in the infant age group (P = 0.03). Cultures were taken from 94 patients (33.7%), and although not statistically significant, cultures were mostly taken from neonatal patients aged28 days (20/49, 40.8%). Applying the criteria, compliance with departmental guidelines was found in 111 (39.8%) of the cases.We found that the use of antimicrobials was judged unnecessary in 17.2% of the patients seen in ChER. There was a poor practice of collecting samples for culture before prescribing antibiotics. Prospective audit and feedback is feasible and it can be done with medical students who will report their findings to consultants and other doctors knowledgeable in principles of antimicrobial therapy. |
| Databáze: | OpenAIRE |
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