Improving the antibiotic duration of therapy with the implementation of antimicrobial lanyard cards and education in a regional hospital

IF 1 Q4 PHARMACOLOGY & PHARMACY

Journal of Pharmacy Practice and Research Pub Date : 2024-02-12 DOI:10.1002/jppr.1902

Lisa Ball MPharm (Hons), Tyrone Fowler BPharm, Kathryn Daveson MBBS, FRACP

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引用次数: 0

Abstract

Background

There is increasing evidence to support reducing antibiotic duration of therapy (DoT). The Therapeutic Guidelines: Antibiotic (version 16 [TG]) have been updated accordingly. However, these recommendations are not consistently followed.

Aim

The project aimed to reduce antibiotic DoT for common infections using antimicrobial lanyard cards and education.

Method

A retrospective pre- and post-implementation audit was undertaken to examine whether antimicrobial stewardship education and lanyard cards defined DoT per infection and severity in accordance with the TG improved antibiotic DoT for common respiratory, urinary, abdominal, and skin infections. Cards were distributed to doctors and pharmacists, with education delivered by an antimicrobial stewardship (AMS) pharmacist. This project was exempt due to the local policy requirements that constitute research by the Darling Downs Hospital and Health Service Human Research Ethics Committee (Reference no: EX/2022/QTDD/86644). The justification for this ethics exemption was as follows: the study conformed with the National Health and Medical Research Council (NHMRC) Ethical considerations in quality assurance and evaluation activities; education was incorporated as part of routine, scheduled sessions ran at Toowoomba hospital and staff were provided with information on the project as part of the education; consent was not required from staff to attend the education nor for using the lanyard cards; the research did not include any assessment of the education program, use of lanyard cards, or involvement of staff.

Results

For all patients an improvement was found in the percentage of antibiotics prescribed per the TG (55–72%, p = 0.0095). This included statistically significant differences for respiratory (42–89%, p = 0.0002), but not for urinary (87–91%, p = 0.99), skin (58–77%, p = 0.3039), or abdominal infections (48–44%, p = 0.6990). The mean total excess treatment days decreased across all infections from 1.86 to 0.95 days (p = 0.0036, 95% confidence interval = −1.52 to −0.30).

Conclusion

The introduction of antibiotic DoT cards, with AMS education, can improve antimicrobial prescribing in line with the TG in a regional hospital.

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一家地区医院通过实施抗菌素挂绳卡和教育改善抗生素治疗持续时间

越来越多的证据支持缩短抗生素疗程（DoT）。治疗指南抗生素治疗指南》（第 16 版 [TG]）已相应更新。该项目旨在利用抗菌药物挂绳卡和教育来缩短常见感染的抗生素治疗时间。我们进行了实施前后的回顾性审计，以检查抗菌药物管理教育和挂绳卡是否按照《治疗指南》规定的每种感染的治疗时间和严重程度改善了常见呼吸道、泌尿、腹部和皮肤感染的抗生素治疗时间。卡片分发给医生和药剂师，并由抗菌药物管理（AMS）药剂师进行教育。根据达令唐斯医院和卫生服务人类研究伦理委员会（编号：EX/2022/QTDD/86644）的当地研究政策要求，该项目可免于伦理审查。获得伦理豁免的理由如下：该研究符合国家健康与医学研究委员会（NHMRC）在质量保证和评估活动中的伦理考虑因素；教育被纳入图文巴医院的例行、计划课程中，并作为教育的一部分向员工提供了有关该项目的信息；参加教育或使用挂绳卡无需征得员工同意；研究不包括对教育计划、挂绳卡的使用或员工参与情况的任何评估。研究发现，所有患者按 TG 开具抗生素处方的比例都有所提高（55%-72%，p = 0.0095）。其中，呼吸道感染（42%-89%，p = 0.0002）、泌尿系统感染（87%-91%，p = 0.99）、皮肤感染（58%-77%，p = 0.3039）或腹部感染（48%-44%，p = 0.6990）的差异具有统计学意义。所有感染的平均超量治疗总天数从 1.86 天降至 0.95 天（p = 0.0036，95% 置信区间 = -1.52 至 -0.30）。

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来源期刊

Journal of Pharmacy Practice and Research Health Professions-Pharmacy

CiteScore

1.60

自引率

9.50%

发文量

期刊介绍： The purpose of this document is to describe the structure, function and operations of the Journal of Pharmacy Practice and Research, the official journal of the Society of Hospital Pharmacists of Australia (SHPA). It is owned, published by and copyrighted to SHPA. However, the Journal is to some extent unique within SHPA in that it ‘…has complete editorial freedom in terms of content and is not under the direction of the Society or its Council in such matters…’. This statement, originally based on a Role Statement for the Editor-in-Chief 1993, is also based on the definition of ‘editorial independence’ from the World Association of Medical Editors and adopted by the International Committee of Medical Journal Editors.