Poor compliance with community-acquired pneumonia antibiotic guidelines in a large Australian private hospital emergency department
| Autor: | Philip Robinson, Helen L Robinson, Michael Whitby |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Microbiology (medical)
Adult medicine.medical_specialty Adolescent medicine.drug_class Concordance Immunology Antibiotics Microbiology Hospitals Private Young Adult Antibiotic resistance Community-acquired pneumonia Health care medicine Humans Hospital Mortality Intensive care medicine Aged Pharmacology Aged 80 and over business.industry Australia Drug Resistance Microbial Guideline Emergency department Pneumonia Middle Aged medicine.disease Anti-Bacterial Agents Community-Acquired Infections Hospitalization Emergency medicine business Emergency Service Hospital |
| Zdroj: | Microbial drug resistance (Larchmont, N.Y.). 20(6) |
| ISSN: | 1931-8448 |
| Popis: | This study evaluated guideline concordance and time to administration of antibiotics in community-acquired pneumonia (CAP) in a private Australian emergency department (ED). Two key components in the management of CAP are timely administration and appropriate choice of antibiotic therapy. The use of antibiotics outside of guidelines can potentially increase rates of antibiotic resistance. Previous studies that evaluate guideline concordance have largely been conducted in Australian public hospitals; however, private hospitals comprise a significant portion of Australian health care.One hundred and thirty patients admitted to a private Brisbane hospital between 01/01/2011 and 28/03/2012 with an admission diagnosis of CAP were included. Data were collected on administration time and choice of antibiotic therapy in the ED. This was compared with local and national CAP guidelines.Concordance with antibiotic guidelines was low (6.9%). Antibiotics with broader spectrum of action than that recommended in guidelines were frequently prescribed. Eighty-one percent of patients received their first antibiotic within 4 hours of arriving in the ED. Mortality was low at 0.9% in a cohort where 31% of patients were aged under 65.We found low rates of concordance with CAP antibiotic guidelines and high use of broad-spectrum antibiotics. This has the potential to lead to increased rates of antibiotic resistance. A subtle alteration to the restrictions within the pharmaceutical benefit scheme formulary could potentially decrease the high usage of broad-spectrum antibiotics. However, the low mortality rate, nontoxic nature of these antibiotics, and the ease of their administration pose a challenge to convincing clinicians to alter their practice. |
| Databáze: | OpenAIRE |
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