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Antibiotic stewardship and early discharge from hospital: impact of a structured approach to antimicrobial management

Antibiotic stewardship and early discharge from hospital: impact of a structured approach to antimicrobial management
Antibiotic stewardship and early discharge from hospital: impact of a structured approach to antimicrobial management
Objectives
To assess the impact of an infection team review of patients receiving antibiotics in six hospitals across the UK and to establish the suitability of these patients for continued care in the community.

Methods
An evaluation audit tool was used to assess all patients on antibiotic treatment on acute wards on a given day. Clinical and antibiotic use data were collected by an infection team (doctor, nurse and antibiotic pharmacist). Assessments were made of the requirement for continuing antibiotic treatment, route and duration [including intravenous (iv)/oral switch] and of the suitability of the patients for discharge from hospital and their requirement for community support.

Results
Of 1356 patients reviewed, 429 (32%) were on systemic antibiotics, comprising 165 (38%) on iv ± oral antibiotics and 264 (62%) on oral antibiotics alone. Ninety-nine (23%) patients (including 26 on iv antibiotics) had their antibiotics stopped immediately on clinical grounds. The other 330 (77%) patients (including 139 on iv antibiotics) needed to continue antibiotics, although 47 (34%) could be switched to oral. Eighty-nine (21%) patients were considered eligible for discharge, comprising 10 who would have required outpatient parenteral antibiotic therapy (OPAT), 55 who were suitable for oral outpatient treatment and 24 who had their antibiotics stopped.

Conclusions
Infection team review had a significant impact on antimicrobial use, facilitating iv to oral switch and a reduction in the volume of antibiotic use, possibly reducing the risk of healthcare-associated complications and infections. It identified many patients who could potentially have been managed in the community with appropriate resources, saving 481 bed-days. The health economics are reported in a companion paper.
0305-7453
2289–2296
Dryden, Matthew
a6c300f9-5c26-4884-980b-c098b0688ab1
Saeed, Kordo
87cb67e5-71e8-4759-bf23-2ea00ebd8b39
Dryden, Matthew
a6c300f9-5c26-4884-980b-c098b0688ab1
Saeed, Kordo
87cb67e5-71e8-4759-bf23-2ea00ebd8b39

Dryden, Matthew and Saeed, Kordo (2012) Antibiotic stewardship and early discharge from hospital: impact of a structured approach to antimicrobial management. Journal of Antimicrobial Chemotherapy, 67 (9), 2289–2296. ().

Record type: Article

Abstract

Objectives
To assess the impact of an infection team review of patients receiving antibiotics in six hospitals across the UK and to establish the suitability of these patients for continued care in the community.

Methods
An evaluation audit tool was used to assess all patients on antibiotic treatment on acute wards on a given day. Clinical and antibiotic use data were collected by an infection team (doctor, nurse and antibiotic pharmacist). Assessments were made of the requirement for continuing antibiotic treatment, route and duration [including intravenous (iv)/oral switch] and of the suitability of the patients for discharge from hospital and their requirement for community support.

Results
Of 1356 patients reviewed, 429 (32%) were on systemic antibiotics, comprising 165 (38%) on iv ± oral antibiotics and 264 (62%) on oral antibiotics alone. Ninety-nine (23%) patients (including 26 on iv antibiotics) had their antibiotics stopped immediately on clinical grounds. The other 330 (77%) patients (including 139 on iv antibiotics) needed to continue antibiotics, although 47 (34%) could be switched to oral. Eighty-nine (21%) patients were considered eligible for discharge, comprising 10 who would have required outpatient parenteral antibiotic therapy (OPAT), 55 who were suitable for oral outpatient treatment and 24 who had their antibiotics stopped.

Conclusions
Infection team review had a significant impact on antimicrobial use, facilitating iv to oral switch and a reduction in the volume of antibiotic use, possibly reducing the risk of healthcare-associated complications and infections. It identified many patients who could potentially have been managed in the community with appropriate resources, saving 481 bed-days. The health economics are reported in a companion paper.

Full text not available from this repository.

More information

Accepted/In Press date: 23 April 2012
e-pub ahead of print date: 23 May 2012
Published date: 1 September 2012

Identifiers

Local EPrints ID: 445034
URI: http://eprints.soton.ac.uk/id/eprint/445034
DOI:
ISSN: 0305-7453
PURE UUID: 8e160611-d484-40ce-a25d-ced5dfad3563
ORCID for Kordo Saeed:

Catalogue record

Date deposited: 18 Nov 2020 17:30
Last modified: 18 Nov 2020 17:30

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Contributors

Author: Matthew Dryden
Author: Kordo Saeed

University divisions

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