Improving appropriateness of antibiotic therapy: randomized trial of an intervention to foster reassessment of prescription after 3 days.
Détails
ID Serval
serval:BIB_311CC4612DE4
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Improving appropriateness of antibiotic therapy: randomized trial of an intervention to foster reassessment of prescription after 3 days.
Périodique
The Journal of Antimicrobial Chemotherapy
ISSN
0305-7453
Statut éditorial
Publié
Date de publication
2004
Peer-reviewed
Oui
Volume
53
Numéro
6
Pages
1062-1067
Langue
anglais
Notes
Publication types: Clinical Trial ; Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
Résumé
OBJECTIVES: Reassessment of ongoing antibiotic therapy is an important step towards appropriate use of antibiotics. This study was conducted to evaluate the impact of a short questionnaire designed to encourage reassessment of intravenous antibiotic therapy after 3 days. PATIENTS AND METHODS: Patients hospitalized on the surgical and medical wards of a university hospital and treated with an intravenous antibiotic for 3-4 days were randomly allocated to either an intervention or control group. The intervention consisted of mailing to the physician in charge of the patient a three-item questionnaire referring to possible adaptation of the antibiotic therapy. The primary outcome was the time elapsed from randomization until a first modification of the initial intravenous antibiotic therapy. It was compared within both groups using Cox proportional-hazard modelling. RESULTS: One hundred and twenty-six eligible patients were randomized in the intervention group and 125 in the control group. Time to modification of intravenous antibiotic therapy was 14% shorter in the intervention group (adjusted hazard ratio for modification 1.28, 95% CI 0.99-1.67, P = 0.06). It was significantly shorter in the intervention group compared with a similar group of 151 patients observed during a 2 month period preceding the study (adjusted hazard ratio 1.17, 95% CI 1.03-1.32, P = 0.02). CONCLUSION: The results suggest that a short questionnaire, easily adaptable to automatization, has the potential to foster reassessment of antibiotic therapy.
Mots-clé
Adult, Aged, Aged, 80 and over, Anti-Bacterial Agents/administration &, dosage, Anti-Bacterial Agents/therapeutic use, Bacterial Infections/drug therapy, Bacterial Infections/microbiology, Decision Support Systems, Clinical, Drug Prescriptions/standards, Female, Follow-Up Studies, Humans, Injections, Intravenous, Male, Middle Aged, Proportional Hazards Models, Quality Assurance, Health Care, Questionnaires, Treatment Outcome
Pubmed
Web of science
Open Access
Oui
Création de la notice
05/03/2008 15:57
Dernière modification de la notice
20/08/2019 13:16