A study, published in the Journal of Hospital Infection, examined the effect of an antimicrobial stewardship program on antibiotic use among outpatients in the emergency department.
Researchers compared the quality of antibiotic prescriptions between November 2012 to October 2013 before the stewardship program was implemented and after its implementation inJune 2015 to May 2016.
They gathered data on antimicrobial prescriptions for all adult outpatients, those hospitalized for less than 24 hours. Before implementation of the program, there were 25,470 outpatient consultations in the ED, and after implementation, there were 26,208 consultations.
Providers prescribed antimicrobials in 3 percent of consultations before the stewardship program was implemented.That figure dropped to 2.2 percent after implementation.
The instances of non-compliance with prescription guidelines dropped from 62.9 percent before implementation to 46.7 percent after implementation. Non-compliance with guidelines included:
● Unnecessary antimicrobial prescriptions — 25.6 percent before the program versus 17.4 percent after implementation
● Inappropriate spectrum — 14 percent versus 9.3 percent
● Excessive treatment duration — 11.3 percent versus 9.1 percent
● Inappropriate choices — 1.4 percent versus 2.6 percent
"The implementation of an ASP dramatically decreased the number of unnecessary antimicrobial prescriptions, but had little impact on most other aspects of inappropriate prescribing," study authors concluded.
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