Antibiotic Guideline Adherence at the Emergency Department: A Descriptive Study from a Country with a Restrictive Antibiotic Policy
Background: Denmark has a low level of antimicrobial resistance (AMR). Patients hospitalized with suspected infection often present with unspecific symptoms. This challenges the physician between using narrow-spectrum antibiotics in accordance with guidelines or broad-spectrum antibiotics to compens...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-11-01
|
| Series: | Antibiotics |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2079-6382/12/12/1680 |
| _version_ | 1797382218215063552 |
|---|---|
| author | Mariana B. Cartuliares Sara N. Søgaard Flemming S. Rosenvinge Christian B. Mogensen Mathias Amdi Hertz Helene Skjøt-Arkil |
| author_facet | Mariana B. Cartuliares Sara N. Søgaard Flemming S. Rosenvinge Christian B. Mogensen Mathias Amdi Hertz Helene Skjøt-Arkil |
| author_sort | Mariana B. Cartuliares |
| collection | DOAJ |
| description | Background: Denmark has a low level of antimicrobial resistance (AMR). Patients hospitalized with suspected infection often present with unspecific symptoms. This challenges the physician between using narrow-spectrum antibiotics in accordance with guidelines or broad-spectrum antibiotics to compensate for diagnostic uncertainty. The aim of this study was to investigate adherence to a restrictive antibiotic guideline for the most common infection in emergency departments (EDs), namely community-acquired pneumonia (CAP). Method: This multicenter descriptive cross-sectional study included adults admitted to Danish EDs with a suspected infection. Data were collected prospectively from medical records. Results: We included 954 patients in the analysis. The most prescribed antibiotics were penicillin with beta-lactamase inhibitor at 4 h (307 (32.2%)), 48 h (289 (30.3%)), and day 5 after admission (218 (22.9%)). The empirical antibiotic treatment guidelines for CAP were followed for 126 (31.3%) of the CAP patients. At 4 h, antibiotics were administered intravenously to 244 (60.7%) of the CAP patients. At day 5, 218 (54.4%) received oral antibiotics. Conclusion: Adherence to CAP guidelines was poor. In a country with a restrictive antibiotic policy, infections are commonly treated with broad-spectrum antibiotics against recommendations. |
| first_indexed | 2024-03-08T21:03:14Z |
| format | Article |
| id | doaj.art-17b0ed7421be4e80b54adbb96b5cab61 |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-08T21:03:14Z |
| publishDate | 2023-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-17b0ed7421be4e80b54adbb96b5cab612023-12-22T13:47:52ZengMDPI AGAntibiotics2079-63822023-11-011212168010.3390/antibiotics12121680Antibiotic Guideline Adherence at the Emergency Department: A Descriptive Study from a Country with a Restrictive Antibiotic PolicyMariana B. Cartuliares0Sara N. Søgaard1Flemming S. Rosenvinge2Christian B. Mogensen3Mathias Amdi Hertz4Helene Skjøt-Arkil5Department of Emergency Medicine, University Hospital of Southern Denmark, 6200 Aabenraa, DenmarkDepartment of Emergency Medicine, University Hospital of Southern Denmark, 6200 Aabenraa, DenmarkDepartment of Clinical Microbiology, Odense University Hospital, 5000 Odense, DenmarkDepartment of Emergency Medicine, University Hospital of Southern Denmark, 6200 Aabenraa, DenmarkDepartment of Infectious Diseases, Odense University Hospital, University of Southern Denmark, 5000 Odense, DenmarkDepartment of Emergency Medicine, University Hospital of Southern Denmark, 6200 Aabenraa, DenmarkBackground: Denmark has a low level of antimicrobial resistance (AMR). Patients hospitalized with suspected infection often present with unspecific symptoms. This challenges the physician between using narrow-spectrum antibiotics in accordance with guidelines or broad-spectrum antibiotics to compensate for diagnostic uncertainty. The aim of this study was to investigate adherence to a restrictive antibiotic guideline for the most common infection in emergency departments (EDs), namely community-acquired pneumonia (CAP). Method: This multicenter descriptive cross-sectional study included adults admitted to Danish EDs with a suspected infection. Data were collected prospectively from medical records. Results: We included 954 patients in the analysis. The most prescribed antibiotics were penicillin with beta-lactamase inhibitor at 4 h (307 (32.2%)), 48 h (289 (30.3%)), and day 5 after admission (218 (22.9%)). The empirical antibiotic treatment guidelines for CAP were followed for 126 (31.3%) of the CAP patients. At 4 h, antibiotics were administered intravenously to 244 (60.7%) of the CAP patients. At day 5, 218 (54.4%) received oral antibiotics. Conclusion: Adherence to CAP guidelines was poor. In a country with a restrictive antibiotic policy, infections are commonly treated with broad-spectrum antibiotics against recommendations.https://www.mdpi.com/2079-6382/12/12/1680antibioticsemergency departmentcommunity-acquired pneumoniaurine tract infection |
| spellingShingle | Mariana B. Cartuliares Sara N. Søgaard Flemming S. Rosenvinge Christian B. Mogensen Mathias Amdi Hertz Helene Skjøt-Arkil Antibiotic Guideline Adherence at the Emergency Department: A Descriptive Study from a Country with a Restrictive Antibiotic Policy Antibiotics antibiotics emergency department community-acquired pneumonia urine tract infection |
| title | Antibiotic Guideline Adherence at the Emergency Department: A Descriptive Study from a Country with a Restrictive Antibiotic Policy |
| title_full | Antibiotic Guideline Adherence at the Emergency Department: A Descriptive Study from a Country with a Restrictive Antibiotic Policy |
| title_fullStr | Antibiotic Guideline Adherence at the Emergency Department: A Descriptive Study from a Country with a Restrictive Antibiotic Policy |
| title_full_unstemmed | Antibiotic Guideline Adherence at the Emergency Department: A Descriptive Study from a Country with a Restrictive Antibiotic Policy |
| title_short | Antibiotic Guideline Adherence at the Emergency Department: A Descriptive Study from a Country with a Restrictive Antibiotic Policy |
| title_sort | antibiotic guideline adherence at the emergency department a descriptive study from a country with a restrictive antibiotic policy |
| topic | antibiotics emergency department community-acquired pneumonia urine tract infection |
| url | https://www.mdpi.com/2079-6382/12/12/1680 |
| work_keys_str_mv | AT marianabcartuliares antibioticguidelineadherenceattheemergencydepartmentadescriptivestudyfromacountrywitharestrictiveantibioticpolicy AT saransøgaard antibioticguidelineadherenceattheemergencydepartmentadescriptivestudyfromacountrywitharestrictiveantibioticpolicy AT flemmingsrosenvinge antibioticguidelineadherenceattheemergencydepartmentadescriptivestudyfromacountrywitharestrictiveantibioticpolicy AT christianbmogensen antibioticguidelineadherenceattheemergencydepartmentadescriptivestudyfromacountrywitharestrictiveantibioticpolicy AT mathiasamdihertz antibioticguidelineadherenceattheemergencydepartmentadescriptivestudyfromacountrywitharestrictiveantibioticpolicy AT heleneskjøtarkil antibioticguidelineadherenceattheemergencydepartmentadescriptivestudyfromacountrywitharestrictiveantibioticpolicy |