Point prevalence of appropriate antimicrobial therapy in a Dutch university hospital

Abstract

Antimicrobial stewardship teams have been shown to increase appropriate empirical antibiotic therapy and reduce medical errors and costs in targeted populations, but the effect in non-targeted populations is still unclear. The aim of this study was to determine the prevalence of inappropriate antibiotic use in a large university hospital and identify areas in which antimicrobial stewardship will be the most effective. In a point prevalence survey we assessed the appropriateness of antibiotic therapy using an electronic surveillance system in combination with a standardized method for duration of therapy, dosage, dosage interval, route of administration, and choice of antibiotic drug. Patients using at least one antibiotic drug were included. Among 996 patients admitted in the surveyed wards, 337 patients (33.8 %) used one or more antibiotic drugs. Two hundred and twenty-one patients (22.2 %) used antibiotic medication therapeutically, with a total of 307 antibiotic prescriptions. Antibiotic therapy was deemed inappropriate in 90 (29.3 %) of these prescribed antibiotics, with an unjustified prescription as the most common reason for an inappropriate prescription. Use of fluoroquinolones and amoxicillin/clavulanic acid and a presumed diagnosis of fever of unknown origin, urinary tract infection, and respiratory tract infection were associated with inappropriate antibiotic therapy. Our study provides insight into the (in)appropriateness of antibiotic prescriptions in a tertiary care center in the Netherlands and identifies areas for improvement. The use of an electronic surveillance system for this point prevalence study is easy and may serve as a baseline measurement for the future effect of antibiotic stewardship.

The Rationality of Antibiotics Therapy Toward Children With Typhoid Fever at M.M. Dunda Hospital

“…Meanwhile, we obtained the example of ceftriaxone which was given 3 times a day in children weighing 19 kg. The results of this study in the IIB category were judged to be greater when compared with previous studies, showing that 6.8% of prescribed antibiotics were not used properly, in part, because of incorrect therapy duration or incorrect dose intervals [20].…”

Antimicrobial prophylaxis outside the operating theatre, an audit in a university hospital

“…A study from Rotterdam reported that 34.4% of hospitalized patients used prophylactic antibiotics, but this included patients using surgical prophylaxis administered in the operating theatre [9]. A study from the Radboud University hospital in the Netherlands reported a percentage of 19.1% for medical prophylaxis, but only antibiotics were investigated [10] .…”

Point prevalence survey of antibiotic use and resistance at a referral hospital in Kenya: findings and implications

“…Antibiotics are indispensable part of modern medicines and the cornerstone for treating bacterial infections across healthcare sectors [1][2][3][4][5]. They are now one of the most common medicines prescribed in hospitals and across sectors [1,6,7] to reduce morbidity and mortality [1,2,7,8].…”