Day 10 Post-Prescription Audit Optimizes Antibiotic Therapy in Patients with Bloodstream Infections
This study aimed to investigate the clinical and organizational impact of an active re-evaluation (on day 10) of patients on antibiotic treatment diagnosed with bloodstream infections (BSIs). A prospective, single center, pre-post quasi-experimental study was performed. Patients were enrolled at the...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-07-01
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| Series: | Antibiotics |
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| Online Access: | https://www.mdpi.com/2079-6382/9/8/437 |
| _version_ | 1797561560053317632 |
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| author | Rita Murri Claudia Palazzolo Francesca Giovannenze Francesco Taccari Marta Camici Teresa Spanu Brunella Posteraro Maurizio Sanguinetti Roberto Cauda Massimo Fantoni |
| author_facet | Rita Murri Claudia Palazzolo Francesca Giovannenze Francesco Taccari Marta Camici Teresa Spanu Brunella Posteraro Maurizio Sanguinetti Roberto Cauda Massimo Fantoni |
| author_sort | Rita Murri |
| collection | DOAJ |
| description | This study aimed to investigate the clinical and organizational impact of an active re-evaluation (on day 10) of patients on antibiotic treatment diagnosed with bloodstream infections (BSIs). A prospective, single center, pre-post quasi-experimental study was performed. Patients were enrolled at the time of microbial BSI confirmation. In the pre-intervention phase (August 2014–August 2015), clinical status and antibiotic regimen were re-evaluated at day 3. In the intervention phase (January 2016–January 2017), clinical status and antibiotic regimen were re-evaluated at day 3 and day 10. Primary outcomes were rate of optimal therapy, duration of antibiotic therapy, length of hospitalization, and 30-day mortality. A total of 632 patients were enrolled (pre-intervention period, <i>n</i> = 303; intervention period, <i>n</i> = 329). Average duration of therapy reduced from 18.1 days (standard deviation (SD), 11.4) in the pre-intervention period to 16.8 days (SD, 12.7) in the intervention period (<i>p</i> < 0.001). Similarly, average length of hospitalization decreased from 24.1 days (SD, 20.8) to 20.6 days (SD, 17.7) (<i>p</i> = 0.001). No inter-group difference was found for the rate of 30-day mortality. In patients with BSI, re-evaluation of clinical status and antibiotic regimen at day 3 and 10 after microbiological diagnosis was correlated with a reduction in the duration of antibiotic therapy and hospital stay. The intervention is simple and has a low impact on overall costs. |
| first_indexed | 2024-03-10T18:16:39Z |
| format | Article |
| id | doaj.art-1f6956cb3b73475b8b30cea8d2064273 |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-10T18:16:39Z |
| publishDate | 2020-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-1f6956cb3b73475b8b30cea8d20642732023-11-20T07:38:44ZengMDPI AGAntibiotics2079-63822020-07-019843710.3390/antibiotics9080437Day 10 Post-Prescription Audit Optimizes Antibiotic Therapy in Patients with Bloodstream InfectionsRita Murri0Claudia Palazzolo1Francesca Giovannenze2Francesco Taccari3Marta Camici4Teresa Spanu5Brunella Posteraro6Maurizio Sanguinetti7Roberto Cauda8Massimo Fantoni9Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, ItalyDipartimento di Sicurezza e Bioetica, Università Cattolica del Sacro Cuore, 00168 Rome, ItalyDipartimento di Sicurezza e Bioetica, Università Cattolica del Sacro Cuore, 00168 Rome, ItalyDipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, ItalyDipartimento di Sicurezza e Bioetica, Università Cattolica del Sacro Cuore, 00168 Rome, ItalyDipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, ItalyDipartimento di Scienze biotecnologiche di base, cliniche intensivologiche e perioperatorie, Università Cattolica del Sacro Cuore, 00168 Rome, ItalyDipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, ItalyDipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, ItalyDipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, ItalyThis study aimed to investigate the clinical and organizational impact of an active re-evaluation (on day 10) of patients on antibiotic treatment diagnosed with bloodstream infections (BSIs). A prospective, single center, pre-post quasi-experimental study was performed. Patients were enrolled at the time of microbial BSI confirmation. In the pre-intervention phase (August 2014–August 2015), clinical status and antibiotic regimen were re-evaluated at day 3. In the intervention phase (January 2016–January 2017), clinical status and antibiotic regimen were re-evaluated at day 3 and day 10. Primary outcomes were rate of optimal therapy, duration of antibiotic therapy, length of hospitalization, and 30-day mortality. A total of 632 patients were enrolled (pre-intervention period, <i>n</i> = 303; intervention period, <i>n</i> = 329). Average duration of therapy reduced from 18.1 days (standard deviation (SD), 11.4) in the pre-intervention period to 16.8 days (SD, 12.7) in the intervention period (<i>p</i> < 0.001). Similarly, average length of hospitalization decreased from 24.1 days (SD, 20.8) to 20.6 days (SD, 17.7) (<i>p</i> = 0.001). No inter-group difference was found for the rate of 30-day mortality. In patients with BSI, re-evaluation of clinical status and antibiotic regimen at day 3 and 10 after microbiological diagnosis was correlated with a reduction in the duration of antibiotic therapy and hospital stay. The intervention is simple and has a low impact on overall costs.https://www.mdpi.com/2079-6382/9/8/437antimicrobial stewardshipbacteremiamedical audit |
| spellingShingle | Rita Murri Claudia Palazzolo Francesca Giovannenze Francesco Taccari Marta Camici Teresa Spanu Brunella Posteraro Maurizio Sanguinetti Roberto Cauda Massimo Fantoni Day 10 Post-Prescription Audit Optimizes Antibiotic Therapy in Patients with Bloodstream Infections Antibiotics antimicrobial stewardship bacteremia medical audit |
| title | Day 10 Post-Prescription Audit Optimizes Antibiotic Therapy in Patients with Bloodstream Infections |
| title_full | Day 10 Post-Prescription Audit Optimizes Antibiotic Therapy in Patients with Bloodstream Infections |
| title_fullStr | Day 10 Post-Prescription Audit Optimizes Antibiotic Therapy in Patients with Bloodstream Infections |
| title_full_unstemmed | Day 10 Post-Prescription Audit Optimizes Antibiotic Therapy in Patients with Bloodstream Infections |
| title_short | Day 10 Post-Prescription Audit Optimizes Antibiotic Therapy in Patients with Bloodstream Infections |
| title_sort | day 10 post prescription audit optimizes antibiotic therapy in patients with bloodstream infections |
| topic | antimicrobial stewardship bacteremia medical audit |
| url | https://www.mdpi.com/2079-6382/9/8/437 |
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