RT Journal Article
SR Electronic
T1 Identifying antibiotic stewardship interventions to meet the NHS England CQUIN: an evaluation of antibiotic ­prescribing against published evidence-based antibiotic audit tools 
JF Clinical Medicine
JO Clin Med
FD Royal College of Physicians
SP 276
OP 281
DO 10.7861/clinmedicine.18-4-276
VO 18
IS 4
A1 Neil Powell
A1 Kate McGraw-Allen
A1 Alasdair Menzies
A1 Bradley Peet
A1 Callie Simmonds
A1 Abigail Wild
YR 2018
UL http://www.rcpjournals.org/content/18/4/276.abstract
AB Evidence-based audit tools were used to identify the antibiotic stewardship improvements necessary to meet the NHS England targets in a 750-bed teaching hospital.Antibiotic prescribing was reviewed against published evidence-based audit tools for 139 patients treated with antibiotics. Severe community-acquired pneumonia (CAP) median course length was 8.5 days. Ninety-six percent of non-severe CAP patients were initiated on intravenous antibiotics (IV); median antibiotic course length 9 days. Twenty-six percent of urinary tract infection (UTI) patients without an indwelling catheter met the UTI diagnostic criteria. IV antibiotics initiated in 79% patients with other infections. Of these, 17% met the IV to oral switch criteria at 72 hours but were not switched. On average, antibiotic courses were 19% longer than recommended. Three key areas for improvement consist of: (a) implement the National Institute of Health and Care Excellence UTI Quality Standard – only 38% of patients treated for UTI met the UTI definition; (b) ensure antibiotic course lengths are in line with local prescribing guidelines – antibiotics were continued for 14% longer than recommended in local guidelines; (c) switch antibiotic therapy to oral when switch criteria met – 17% percent of patients initiated on IV antibiotics were eligible for oral switch by 72 hours and were not switched.