title: Measuring appropriate use of antibiotics in pyelonephritis in Belgian hospitals.
abstract: Inappropriate use of antibiotics can induce antibiotic resistance, treatment failure, increased costs and even mortality. We developed a methodology for measuring guideline compliance of hospital antibiotic prescriptions in community-acquired acute pyelonephritis in Belgium. The claims and clinical data of all Belgian hospitalizations for community-acquired acute pyelonephritis were extracted from a nationwide administrative database. In a clinically homogeneous subset of patients, the percentage of patients who received a guideline-compliant prescription was calculated according to prescription guidelines disseminated in Belgium. In the group of non-pregnant adult female patients, 31% of the prescriptions were not in strict compliance with the guideline. Interhospital variability ranged from 0% to 100% compliance. We conclude that administrative databases can be used to analyze antibiotic prescription behavior in hospitals for homogeneous and clinically relevant patient groups. The interhospital variability observed in Belgian hospitals indicate that there is a clear room for improvement.
authors.affiliation: Belgian Health Care Knowledge Centre (KCE), Centre administratif Botanique, Door Building (10 eme etage), Boulevard du Jardin Botanique 55, 1040 Brussels, Belgium. cecile.camberlin@kce.fgov.be
authors.forename: Cécile
authors.initials: C
authors.lastname: Camberlin
authors.forename: Dirk
authors.initials: D
authors.lastname: Ramaekers
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001530:Belgium; D002648:Child; D002675:Child, Preschool; D011307:Drug Prescriptions; D004352:Drug Resistance, Microbial; D004363:Drug Utilization; D005260:Female; D019983:Guideline Adherence; D006760:Hospitalization; D006761:Hospitals; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000191:economics; D011704:Pyelonephritis / Q000188:drug therapy*
chemical_list: D000900:Anti-Bacterial Agents