Antimicrobial prescribing at a university hospital: justified or 'just in case': testing a new scoring system as a key quality indicator.
OBJECTIVE
To evaluate the quality of antimicrobial drug prescribing at a university hospital in the Department of Medicine, by using a new scoring system as a quality indicator.


METHODS



METHODS
a prospective, longitudinal survey, during a 21-week period. The necessity of antimicrobial treatment of all in-patients at the Department of Medicine, to whom new antimicrobials were prescribed, was assessed by using a scoring system based on the presence of signs and symptoms of an infection. If the sum's total score was 3 or more, the antimicrobial treatment was deemed justifiable; if the score was less than 3, the antimicrobial treatment was regarded as questionable.


METHODS
Department of Medicine (279 hospital-beds) at the University Hospital Center Rijeka, a 1200-patient-bed teaching hospital in Croatia.


RESULTS
Antimicrobials were prescribed to 15% of the total patients. They were given as a treatment to 89% of the patients, and in 67% of the cases, this treatment was administered empirically. According to the scoring system, 29% of the patients did not have a justified indication for antimicrobial treatment.


CONCLUSIONS
The proposed quality indicator (scoring system) that we used is a simple method for the quality assessment of antimicrobial use. It has indicated areas that require in-depth analysis.
Vlahović-Palcevski
Vera
V
Unit for Clinical Pharmacology, University Hospital Center Rijeka, University of Rijeka Medical School, Rijeka, Croatia. vvlahovic@inet.hr
Francetić
Igor
I
Palcevski
Goran
G
Novak
Srdan
S
Bergman
Ulf
U
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy* / Q000453:epidemiology; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000382:microbiology; D017523:Croatia / Q000453:epidemiology; D011307:Drug Prescriptions / Q000592:standards*; D005260:Female; D006748:Hospital Departments / Q000706:statistics & numerical data; D006785:Hospitals, University; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011446:Prospective Studies; D011785:Quality Assurance, Health Care
D000890:Anti-Infective Agents