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Identifying antibiotic stewardship interventions to meet the NHS England CQUIN: an evaluation of antibiotic prescribing against published evidence-based antibiotic audit tools

Clinical medicine (London, England), 2018-08, Vol.18 (4), p.276-281 [Peer Reviewed Journal]

2018 © 2018 THE AUTHORS. Published by Elsevier Limited on behalf of the Royal College of Physicians. ;Royal College of Physicians 2018. All rights reserved. ;Copyright Royal College of Physicians Aug 2018 ;Royal College of Physicians 2018. All rights reserved. 2018 ;ISSN: 1470-2118 ;EISSN: 1473-4893 ;DOI: 10.7861/clinmedicine.18-4-276 ;PMID: 30072548

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Title:
Identifying antibiotic stewardship interventions to meet the NHS England CQUIN: an evaluation of antibiotic prescribing against published evidence-based antibiotic audit tools
Author: Powell, Neil ; McGraw-Allen, Kate ; Menzies, Alasdair ; Peet, Bradley ; Simmonds, Callie ; Wild, Abigail
Subjects: Adults ; Anti-Bacterial Agents - therapeutic use ; Antibiotic stewardship ; Antibiotics ; Antimicrobial agents ; Antimicrobial Stewardship - methods ; Antimicrobial Stewardship - standards ; Antimicrobial Stewardship - statistics & numerical data ; audit ; Audits ; Bacterial Infections - drug therapy ; Bacterial Infections - epidemiology ; Bioavailability ; Clinical Audit ; Clinical medicine ; Community-Acquired Infections - drug therapy ; Community-Acquired Infections - epidemiology ; Computerized physician order entry ; England ; Evidence-Based Practice ; Female ; Hospitals, Teaching ; Humans ; Lung diseases ; Male ; Medical records ; Original Research ; Patients ; Pharmacists ; Pneumonia ; Pneumonia - drug therapy ; Pneumonia - epidemiology ; Staphylococcus infections ; Systematic review ; Urinary tract diseases ; Urinary tract infections ; Urinary Tract Infections - drug therapy ; Urinary Tract Infections - epidemiology ; Urogenital system
Is Part Of: Clinical medicine (London, England), 2018-08, Vol.18 (4), p.276-281
Description: Evidence-based audit tools were used to identify the antibiotic stewardship improvements necessary to meet the NHS England targets in a 750-bed teaching hospital. Antibiotic prescribing was reviewed against published evidence-based audit tools for 139 patients treated with antibiotics. Severe community-acquired pneumonia (CAP) median course length was 8.5 days. Ninety-six percent of non-severe CAP patients were initiated on intravenous antibiotics (IV); median antibiotic course length 9 days. Twenty-six percent of urinary tract infection (UTI) patients without an indwelling catheter met the UTI diagnostic criteria. IV antibiotics initiated in 79% patients with other infections. Of these, 17% met the IV to oral switch criteria at 72 hours but were not switched. On average, antibiotic courses were 19% longer than recommended. Three key areas for improvement consist of: (a) implement the National Institute of Health and Care Excellence UTI Quality Standard – only 38% of patients treated for UTI met the UTI definition; (b) ensure antibiotic course lengths are in line with local prescribing guidelines – antibiotics were continued for 14% longer than recommended in local guidelines; (c) switch antibiotic therapy to oral when switch criteria met – 17% percent of patients initiated on IV antibiotics were eligible for oral switch by 72 hours and were not switched.
Publisher: England: Elsevier Ltd
Language: English
Identifier: ISSN: 1470-2118
EISSN: 1473-4893
DOI: 10.7861/clinmedicine.18-4-276
PMID: 30072548
Source: Journals@Ovid Open Access Journal Collection Rolling
MEDLINE
PubMed Central
ProQuest Central

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Identifying antibiotic stewardship interventions to meet the NHS England CQUIN: an evaluation of antibiotic ­prescribing against published evidence-based antibiotic audit tools

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Identifying antibiotic stewardship interventions to meet the NHS England CQUIN: an evaluation of antibiotic prescribing against published evidence-based antibiotic audit tools