Point prevalence study of antibiotic appropriateness and possibility of early discharge from hospital among patients treated with antibiotics in a Swiss University Hospital.

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Etat: Public
Version: de l'auteur⸱e
Licence: CC BY 4.0
ID Serval
serval:BIB_36B2DBB12BAA
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Point prevalence study of antibiotic appropriateness and possibility of early discharge from hospital among patients treated with antibiotics in a Swiss University Hospital.
Périodique
Antimicrobial resistance and infection control
Auteur⸱e⸱s
Moulin E., Boillat-Blanco N., Zanetti G., Plüss-Suard C., de Vallière S., Senn L.
ISSN
2047-2994 (Electronic)
ISSN-L
2047-2994
Statut éditorial
Publié
Date de publication
07/05/2022
Peer-reviewed
Oui
Volume
11
Numéro
1
Pages
66
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: epublish
Résumé
The growing threat of multidrug resistant organisms have led to increasingly promote prudent and rational use of antimicrobials as well as early hospital discharge plan. Antibiotic stewardship programs (ASP) have been developed as multifaceted approaches to improve use of current antibiotics and are now widely applied through different strategies. Proactive interventions are still limited in Switzerland and data on antimicrobial appropriateness and early discharge strategies are lacking. We aimed to describe the opportunities of antibiotics prescriptions optimization at Lausanne University Hospital, Switzerland and evaluate the suitability for early discharge among patients receiving antibiotics. The need for outpatient medical structures was also assessed.
We conducted a point prevalence survey of antibiotic prescriptions in adult medical and surgical units with exclusion of intermediate and intensive care units. All hospitalized patients receiving a systemic antibiotic on the day of evaluation were included. An infectious diseases specialist evaluated antimicrobial appropriateness and assessed suitability for discharge according to medical and nursing observations. The need of flexible additional outpatient facility for a close medical follow-up was evaluated concomitantly.
A total of 564 patients' files were reviewed. 182 (32%) patients received one or more systemic antibiotic: 62 (34%) as a prophylaxis and 120 (66%) as a treatment with or without concomitant prophylaxis. 37/62 (60%) patients receiving prophylaxis had no indication to continue the antibacterial. Regarding the patients treated with antibiotics, 69/120 (58%) presented at least one opportunity for treatment optimization, mainly interruption of treatment. A previous ID consultation was recorded for 55/120 (46%) patients, of whom 21 (38%) could have benefited from antimicrobial therapy optimization on the day of the point assessment. 9.2% patients were eligible for discharge of whom 64% could leave the hospital with a close outpatient follow-up for infectious issues.
This point prevalence study offers precious indicators for tailoring future antibiotic stewardship interventions that can be combined with early discharge. Any centre considering implementing ASP should conduct this type of analysis with a pragmatic approach to gain insight into local practices and needed resources.
Mots-clé
Adult, Anti-Bacterial Agents/therapeutic use, Anti-Infective Agents/therapeutic use, Communicable Diseases/drug therapy, Hospitals, University, Humans, Patient Discharge, Prevalence, Switzerland/epidemiology, Antibiotic stewardship programs, Early discharge, Outpatient parenteral therapy
Pubmed
Web of science
Open Access
Oui
Création de la notice
20/05/2022 17:23
Dernière modification de la notice
12/02/2024 11:40
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