Implementation of an educational program and an antibiotic order form to optimize quality of antimicrobial drug use in a department of internal medicine

The Effect of a 4th Generation-Cephalosporin Introduction upon the Incidence of Multidrug-Resistant Gram-Negative Bacteria in a Non-Teaching Hospital

“…The excessive and inappropriate use of antimicrobials is the main cause underlying the emergence of resistance and continues to be a problem despite the existence of published guidelines and the implementation of antimicrobial restriction policies in many hospitals [10][11][12][13] . Several strategies for regulating antimicrobial prescribing practices have been proposed, such as: formulary replacement or restriction [14] ; introduction of order forms [15] ; education programs for health care providers; feedback activities [16] ; and approval required from the infectious diseases physician for drug prescription [17] . There are two major approaches to reducing excessive or inappropriate use of antimicrobials: those that attempt to optimize usage and those that tend to optimize the availability of specific agents [18] .…”

Reliability of assessment of adherence to an antimicrobial treatment guideline

“…28 In some studies, disagreement between observers was resolved by having a single observer, which ensured consistent analysis but carried the risk of consistent wrong assessments being made. 10,14,31 Another approach described was co-review of each case, which was feasible in experimental situations but might be excessively labour intensive in continuously running programmes.…”

“…In some of these studies, an infectious disease specialist reviewed medical charts to assess adherence to a guideline. [7][8][9][10][11][12] In other studies, junior clinical or hospital pharmacists, internists or residents, and clinical microbiologists reviewed prescribing appropriateness or adherence. [4][5][6][13][14][15][16][17][18][19][20] However, low to moderate agreement was found by some authors in assessments.…”

“…[4][5][6][13][14][15][16][17][18][19][20] However, low to moderate agreement was found by some authors in assessments. 10,17 Satisfactory levels of agreement were only found between professionals of the same professional background, such as between hospital pharmacists, using the medication appropriateness index, an assessment tool for appropriate prescribing. 21 Any assessment method needs to be reliable and credible for the target group being assessed.…”

Can audit improve antibiotic prescribing in general dental practice?

“…[7][8][9][10] In contrast, very few audits on antibiotic prescribing in dental practice have been reported. 11,12 It has been suggested that the production of guidelines for general dental practitioners (GDPs) along with educational initiatives and audit may encourage safe, effective, rational and economic use of antibiotics and at the same time reduce the likelihood of dentists contributing to the problem of antibiotic resistance.…”