title: Impact of standardised review of intravenous antibiotic therapy 72 hours after prescription in two internal medicine wards.
abstract: Post-prescription review of hospital antibiotic therapy may contribute to more appropriate use. We estimated the impact of a standardised review of intravenous antibiotic therapy three days after prescription in two internal medicine wards of a university hospital. In one ward, we assessed the charts of patients under intravenous antibiotic therapy using a standardised review process and provided feedback to the prescriber. There was no intervention in the other ward. After six months we crossed the allocation between the two wards. In all, 204 courses of antibiotic therapy were included in the intervention periods and 226 in the control periods. Post-prescription review led to proposals for modification in 46% of antibiotic courses. Time to treatment modification was 22% shorter in the intervention periods compared with the control periods (3.9+/-5.2 days vs 5.0+/-6.0 days, P=0.007). Patients included in the intervention group had lower antibiotic consumption than patients in the control group, but the intervention had no significant impact on the overall antibiotic consumption of the two wards.
authors.affiliation: Service of Hospital Preventive Medicine and Service of Infectious Diseases, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland. oriol.manuel@chuv.ch
authors.forename: O
authors.initials: O
authors.lastname: Manuel
authors.forename: B
authors.initials: B
authors.lastname: Burnand
authors.forename: P
authors.initials: P
authors.lastname: Bady
authors.forename: R
authors.initials: R
authors.lastname: Kammerlander
authors.forename: M
authors.initials: M
authors.lastname: Vansantvoet
authors.forename: P
authors.initials: P
authors.lastname: Francioli
authors.forename: G
authors.initials: G
authors.lastname: Zanetti
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy*; D017723:Drug Utilization Review / Q000379:methods* / Q000592:standards; D005260:Female; D006302:Health Services Research; D006761:Hospitals; D006801:Humans; D007262:Infusions, Intravenous; D007388:Internal Medicine; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents