Impact of printed antimicrobial stewardship recommendations on early intravenous to oral antibiotics switch practice in district hospitals
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| Formato: | Artículo científico |
| Lenguaje: | en |
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Centro de investigaciones y Publicaciones Farmacéuticas
2018
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| _version_ | 1876442587084095488 |
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| author | Wei T. Sze |
| author_facet | Wei T. Sze |
| contents | Impact of printed antimicrobial stewardship recommendations on early intravenous to oral antibiotics switch practice in district hospitals Wei T. Sze Mei C. Kong Medicina Anti Hospital Malaysia Pharmacists Bacterial Agents Background: Early intravenous to oral (IV-PO) antibiotics switch, which is one of the important elements in antimicrobial stewardship (AMS) is not well implemented in Malaysian district hospitals. A systematic interventional strategy is required to facilitate IV-PO antibiotic switch.Objective: This study aimed to evaluate the impact of printed AMS recommendations on early IV-PO antibiotics switch practice in district hospitals.Methods: This study was an interventional study conducted in medical wards of eight Sarawak district hospitals from May to August 2015. In pre-intervention phase, pharmacists performed the conventional practice of reviewing medication charts and verbally informed the prescribers on eligible IV-PO switches. In post-intervention phase, pharmacists attached printed checklist which contained IV-PO switch criteria to patients’ medical notes on the day patients were eligible for the switch. Stickers of IV-PO switch were applied to the antibiotic prescription to serve as reminders.Results: 79 and 77 courses of antibiotics were studied in the pre-intervention phase and post-intervention phase respectively. Timeliness of switch was improved by 1.63 days in the post-intervention phase (95%CI 1.26:2.00 days, p<0.001). Mean duration of IV antibiotics in the post-intervention phase was shorter than pre-intervention phase (2.81 days (SD=1.77) vs 4.05 days (SD=2.81), p<0.001). The proportion of IV-PO switches that were only performed upon discharge reduced significantly in the post-intervention phase (31.2% vs 82.3%, p<0.001). Length of hospital stay in the post-intervention phase was shortened by 1.44 days (p<0.001). Median antibiotic cost savings increased significantly in the post-intervention phase compared to the pre-intervention phase MYR21.96 (IQR=23.23) vs MYR13.10 (IQR=53.76); p=0.025).Conclusions: Pharmacist initiated printed AMS recommendations are successful in improving the timeliness of IV-PO switch, reducing the duration of IV, reducing the length of hospitalisation, and increasing antibiotic cost savings. 2018 artículo científico 1885-642X https://www.redalyc.org/articulo.oa?id=69061110001 https://www.redalyc.org/journal/690/69061110001/ https://www.redalyc.org/journal/690/69061110001/html/ https://www.redalyc.org/journal/690/69061110001/69061110001.epub https://www.redalyc.org/journal/690/69061110001/movil 10.18549/PharmPract.2018.02.855 en http://www.redalyc.org/revista.oa?id=690 Pharmacy Practice application/pdf Centro de investigaciones y Publicaciones Farmacéuticas Pharmacy Practice (España) Num.2 Vol.16 |
| format | Artículo científico |
| id | redalyc_69061110001 |
| institution | Redalyc |
| language | en |
| publishDate | 2018 |
| publisher | Centro de investigaciones y Publicaciones Farmacéuticas |
| spellingShingle | Impact of printed antimicrobial stewardship recommendations on early intravenous to oral antibiotics switch practice in district hospitals Wei T. Sze Medicina Anti Hospital Malaysia Pharmacists Bacterial Agents Impact of printed antimicrobial stewardship recommendations on early intravenous to oral antibiotics switch practice in district hospitals Wei T. Sze Mei C. Kong Medicina Anti Hospital Malaysia Pharmacists Bacterial Agents Background: Early intravenous to oral (IV-PO) antibiotics switch, which is one of the important elements in antimicrobial stewardship (AMS) is not well implemented in Malaysian district hospitals. A systematic interventional strategy is required to facilitate IV-PO antibiotic switch.Objective: This study aimed to evaluate the impact of printed AMS recommendations on early IV-PO antibiotics switch practice in district hospitals.Methods: This study was an interventional study conducted in medical wards of eight Sarawak district hospitals from May to August 2015. In pre-intervention phase, pharmacists performed the conventional practice of reviewing medication charts and verbally informed the prescribers on eligible IV-PO switches. In post-intervention phase, pharmacists attached printed checklist which contained IV-PO switch criteria to patients’ medical notes on the day patients were eligible for the switch. Stickers of IV-PO switch were applied to the antibiotic prescription to serve as reminders.Results: 79 and 77 courses of antibiotics were studied in the pre-intervention phase and post-intervention phase respectively. Timeliness of switch was improved by 1.63 days in the post-intervention phase (95%CI 1.26:2.00 days, p<0.001). Mean duration of IV antibiotics in the post-intervention phase was shorter than pre-intervention phase (2.81 days (SD=1.77) vs 4.05 days (SD=2.81), p<0.001). The proportion of IV-PO switches that were only performed upon discharge reduced significantly in the post-intervention phase (31.2% vs 82.3%, p<0.001). Length of hospital stay in the post-intervention phase was shortened by 1.44 days (p<0.001). Median antibiotic cost savings increased significantly in the post-intervention phase compared to the pre-intervention phase MYR21.96 (IQR=23.23) vs MYR13.10 (IQR=53.76); p=0.025).Conclusions: Pharmacist initiated printed AMS recommendations are successful in improving the timeliness of IV-PO switch, reducing the duration of IV, reducing the length of hospitalisation, and increasing antibiotic cost savings. 2018 artículo científico 1885-642X https://www.redalyc.org/articulo.oa?id=69061110001 https://www.redalyc.org/journal/690/69061110001/ https://www.redalyc.org/journal/690/69061110001/html/ https://www.redalyc.org/journal/690/69061110001/69061110001.epub https://www.redalyc.org/journal/690/69061110001/movil 10.18549/PharmPract.2018.02.855 en http://www.redalyc.org/revista.oa?id=690 Pharmacy Practice application/pdf Centro de investigaciones y Publicaciones Farmacéuticas Pharmacy Practice (España) Num.2 Vol.16 |
| title | Impact of printed antimicrobial stewardship recommendations on early intravenous to oral antibiotics switch practice in district hospitals |
| topic | Medicina Anti Hospital Malaysia Pharmacists Bacterial Agents |
| url | https://www.redalyc.org/articulo.oa?id=69061110001 https://www.redalyc.org/journal/690/69061110001/ https://www.redalyc.org/journal/690/69061110001/html/ https://www.redalyc.org/journal/690/69061110001/69061110001.epub https://www.redalyc.org/journal/690/69061110001/movil |