An interrupted time series analysis of parenteral antibiotic use in Colombia.
A University-based hospital in Bogotá, Colombia, developed and implemented an educational intervention to complement a new structured antibiotic order form. This intervention was performed after assessing the appropriateness of the observed antibiotic prescribing practices using a quasi-experimental study. An application of interrupted time series intervention analysis was conducted in three antibiotic groups (aminoglycosides, cephradine/cephalothin, and ceftazidime/cefotaxime) and their hospital weekly rate of incorrect prescriptions before and after the intervention. A fourth time series was defined on prophylactic antibiotic use in elective surgery. Preintervention models were used in the postintervention series to test for pre-post series level differences. An abrupt constant change was significant in the first, third, and fourth time series indicating a 47, 7.3, and 20% reduction of incorrect prescriptions after the intervention. We conclude that a structured antibiotic order form, coupled with graphic and educational interventions can improve antibiotic use in a university hospital.
Clinical Epidemiology and Biostatistics Unit, Pontificia Universidad Javeriana, Bogotá, Colombia. adriana.perez@uth.tmc.edu
Adriana
A
Pérez
Rodolfo J
RJ
Dennis
Benigno
B
Rodríguez
Amparo Y
AY
Castro
Victor
V
Delgado
Juan Manuel
JM
Lozano
Maria Clara
MC
Castro
D000617:Aminoglycosides / Q000008:administration & dosage; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D019072:Antibiotic Prophylaxis / Q000592:standards; D002437:Cefazolin / Q000008:administration & dosage; D002515:Cephradine / Q000008:administration & dosage; D002983:Clinical Competence; D003105:Colombia; D003906:Developing Countries; D011307:Drug Prescriptions / Q000592:standards*; D017723:Drug Utilization Review / Q000379:methods*; D004502:Education, Medical, Continuing; D017144:Focus Groups; D005572:Formularies, Hospital as Topic / Q000592:standards; D006784:Hospitals, Teaching / Q000592:standards*; D006801:Humans; D008505:Medical Staff, Hospital / Q000193:education; D015233:Models, Statistical
D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D002515:Cephradine; D002437:Cefazolin