Poor compliance with an antibiotic directive—A call for intensified monitoring
Background: In April 2017, the Central Denmark Region Antibiotic Stewardship Committee issued a directive to reduce the general use of piperacillin-tazobactam and prescribe narrow-spectrum antibiotics for mild and moderate pneumonia. The directive was distributed to all regional hospital clinicians....
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2021-03-01
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| Series: | International Journal of Infectious Diseases |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1201971221000394 |
| _version_ | 1831585639144882176 |
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| author | Frederik Novak Jens T. Hørlück Jacob D. Redder Paul W. Denton Merete Storgaard |
| author_facet | Frederik Novak Jens T. Hørlück Jacob D. Redder Paul W. Denton Merete Storgaard |
| author_sort | Frederik Novak |
| collection | DOAJ |
| description | Background: In April 2017, the Central Denmark Region Antibiotic Stewardship Committee issued a directive to reduce the general use of piperacillin-tazobactam and prescribe narrow-spectrum antibiotics for mild and moderate pneumonia. The directive was distributed to all regional hospital clinicians. Methods: Electronic medical records were used to obtain de-identified details of all antibiotics administered (together with diagnosis codes) to all in-hospital patients (pre-directive and post-directive) in the nine regional hospitals. Average moving range statistical process control charts were used to analyze pre-directive and post-directive variation in antibiotic usage patterns. Results: Upon the distribution of the directive, a period of decline of the overall usage of piperacillin-tazobactam ensued. Rather than benzylpenicillin, as recommended for pneumonia, the initial decline in piperacillin/tazobactam usage was accompanied by increased use of cefuroxime. Conclusions: A steward-directed reduction in piperacillin-tazobactam usage was accompanied by less desirable usage of a broad-spectrum alternative. Future antibiotic stewardship initiatives will hopefully benefit from close monitoring and timely feedback to clinicians. A dialogue with clinicians based on near real-time data is predicted to improve antibiotic stewardship actions. |
| first_indexed | 2024-12-17T21:22:11Z |
| format | Article |
| id | doaj.art-f4fefd72a2444deb967464a94f30a99b |
| institution | Directory Open Access Journal |
| issn | 1201-9712 |
| language | English |
| last_indexed | 2024-12-17T21:22:11Z |
| publishDate | 2021-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Infectious Diseases |
| spelling | doaj.art-f4fefd72a2444deb967464a94f30a99b2022-12-21T21:32:11ZengElsevierInternational Journal of Infectious Diseases1201-97122021-03-01104474478Poor compliance with an antibiotic directive—A call for intensified monitoringFrederik Novak0Jens T. Hørlück1Jacob D. Redder2Paul W. Denton3Merete Storgaard4Department of Infectious Diseases, Aarhus University Hospital, Skejby, Aarhus, DenmarkDEFACTUM, Central Denmark Region, Aarhus, DenmarkBusiness Intelligence Office, Department of Information Technology, Central Denmark Region, Aarhus, DenmarkDepartment of Infectious Diseases, Aarhus University Hospital, Skejby, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Universityof Nebraska at Omaha, Department of Biology, Omaha, Nebraska, USADepartment of Infectious Diseases, Aarhus University Hospital, Skejby, Aarhus, Denmark; Corresponding author at: Department of Infectious Diseases, Aarhus University Hospital, Skejby, 8200 Aarhus, Denmark.Background: In April 2017, the Central Denmark Region Antibiotic Stewardship Committee issued a directive to reduce the general use of piperacillin-tazobactam and prescribe narrow-spectrum antibiotics for mild and moderate pneumonia. The directive was distributed to all regional hospital clinicians. Methods: Electronic medical records were used to obtain de-identified details of all antibiotics administered (together with diagnosis codes) to all in-hospital patients (pre-directive and post-directive) in the nine regional hospitals. Average moving range statistical process control charts were used to analyze pre-directive and post-directive variation in antibiotic usage patterns. Results: Upon the distribution of the directive, a period of decline of the overall usage of piperacillin-tazobactam ensued. Rather than benzylpenicillin, as recommended for pneumonia, the initial decline in piperacillin/tazobactam usage was accompanied by increased use of cefuroxime. Conclusions: A steward-directed reduction in piperacillin-tazobactam usage was accompanied by less desirable usage of a broad-spectrum alternative. Future antibiotic stewardship initiatives will hopefully benefit from close monitoring and timely feedback to clinicians. A dialogue with clinicians based on near real-time data is predicted to improve antibiotic stewardship actions.http://www.sciencedirect.com/science/article/pii/S1201971221000394Antibiotic stewardshipElectronic monitoringAntibiotic usage |
| spellingShingle | Frederik Novak Jens T. Hørlück Jacob D. Redder Paul W. Denton Merete Storgaard Poor compliance with an antibiotic directive—A call for intensified monitoring International Journal of Infectious Diseases Antibiotic stewardship Electronic monitoring Antibiotic usage |
| title | Poor compliance with an antibiotic directive—A call for intensified monitoring |
| title_full | Poor compliance with an antibiotic directive—A call for intensified monitoring |
| title_fullStr | Poor compliance with an antibiotic directive—A call for intensified monitoring |
| title_full_unstemmed | Poor compliance with an antibiotic directive—A call for intensified monitoring |
| title_short | Poor compliance with an antibiotic directive—A call for intensified monitoring |
| title_sort | poor compliance with an antibiotic directive a call for intensified monitoring |
| topic | Antibiotic stewardship Electronic monitoring Antibiotic usage |
| url | http://www.sciencedirect.com/science/article/pii/S1201971221000394 |
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