PT  - JOURNAL ARTICLE
AU  - Neil Powell
AU  - Jennie Stephens
AU  - Rory Rule
AU  - Ryan Phillips
AU  - Megan Morphew
AU  - Emma Garry
AU  - Natasha Askaroff
AU  - Daniel Hiley
AU  - Charlie Strachan
AU  - Myles Sheehan
AU  - Caitlin McDonald
TI  - Potential to reduce antibiotic use in secondary care: Single-centre process audit of prescription duration using NICE guidance for common infections
AID  - 10.7861/clinmed.2020-0141
DP  - 2021 Jan 01
TA  - Clinical Medicine
PG  - e39--e44
VI  - 21
IP  - 1
4099  - http://www.rcpjournals.org/content/21/1/e39.short
4100  - http://www.rcpjournals.org/content/21/1/e39.full
SO  - Clin Med2021 Jan 01; 21
AB  - Introduction Antibiotic use drives antibiotic resistance. Reducing antibiotic use through reducing antibiotic course lengths could contribute to the UK national ambition to reduce total antibiotic use.Methods Medical notes were reviewed for patients who had received at least 5 days of antibiotic therapy; had been discharged in January 2019; and were from a 750-bed acute secondary care hospital in England. UK national guidelines were used to determine the excess antibiotic use in common medical infections: community-acquired pneumonia (CAP), hospital-acquired pneumonia (HAP), pyelonephritis, cellulitis, infective exacerbation of chronic obstructive pulmonary disease (IECOPD) and cholangitis.Results Four-hundred and twenty-three patients met the inclusion criteria. Of these, 307 (73%) patient notes were retrieved and reviewed. One-hundred and seventy-three patients met the study case definitions, of which, 137 met short course criteria.Potential antibiotic reductions (measured in defined daily doses) were identified for five of the six infections: 32% in CAP, 20% in HAP, 14% in IECOPD, 11% in cellulitis and 10% in pyelonephritis. These reductions were estimated to reduce total antibiotic use in medical specialties by 12.4%, which equates to 3.6% of the hospital's total antibiotic use.Conclusion Clinical application of the evidence-based guidance for shorter antibiotic course lengths appears to be a valid strategy for reducing total antibiotic consumption.