Improving appropriateness of antibiotic therapy: randomized trial of an intervention to foster reassessment of prescription after 3 days.

Details

Serval ID
serval:BIB_311CC4612DE4
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Improving appropriateness of antibiotic therapy: randomized trial of an intervention to foster reassessment of prescription after 3 days.
Journal
The Journal of Antimicrobial Chemotherapy
Author(s)
Senn L., Burnand B., Francioli P., Zanetti G.
ISSN
0305-7453
Publication state
Published
Issued date
2004
Peer-reviewed
Oui
Volume
53
Number
6
Pages
1062-1067
Language
english
Notes
Publication types: Clinical Trial ; Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
Abstract
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.
Keywords
Adult, Aged, Aged, 80 and over, Anti-Bacterial Agents/administration &amp, 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
Yes
Create date
05/03/2008 15:57
Last modification date
20/08/2019 13:16
Usage data