RT Journal Article
SR Electronic
T1 Potential to reduce antibiotic use in secondary care: Single-centre process audit of prescription duration using NICE guidance for common infections
JF Clinical Medicine
JO Clin Med
FD Royal College of Physicians
SP e39
OP e44
DO 10.7861/clinmed.2020-0141
VO 21
IS 1
A1 Neil Powell
A1 Jennie Stephens
A1 Rory Rule
A1 Ryan Phillips
A1 Megan Morphew
A1 Emma Garry
A1 Natasha Askaroff
A1 Daniel Hiley
A1 Charlie Strachan
A1 Myles Sheehan
A1 Caitlin McDonald
YR 2021
UL http://www.rcpjournals.org/content/21/1/e39.abstract
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.