title: A multidisciplinary intervention to reduce antibiotic duration in lower respiratory tract infections.
abstract: OBJECTIVE
  Prolonged antibiotic courses are common in patients with lower respiratory tract infections (LRTIs) and contribute to antibiotic resistance and side effects. This study describes a multidisciplinary intervention to reduce antibiotic duration in LRTI patients.
  
  
  METHODS
  This was a prospective before-and-after intervention study conducted from November 2011 to December 2012. Antibiotic duration was recorded for 6 months for all LRTI admissions (pneumonia, exacerbation of chronic obstructive pulmonary disease, exacerbation of asthma, and other LRTIs), followed by the introduction of an intervention intended to reduce the duration of antibiotic treatment. The intervention incorporated an antibiotic duration based on the CURB65 score, automatic stop dates and pharmacist feedback to prescribers.
  
  
  RESULTS
  Two hundred and eighty-one patients were included in the pre-intervention group and 221 in the post-intervention group. The intervention resulted in a reduction in the duration of antibiotic treatment from 8.3 to 6.8 days (P < 0.001, 18.1% relative reduction). The rate of antibiotic-related adverse effects reduced from 31% to 19% (P = 0.03, 39.3% relative reduction). There was no increase in mortality or length of stay
  
  
  CONCLUSIONS
  A simple intervention can significantly reduce antibiotic duration and antibiotic-related side effects.
authors.affiliation: Tayside Respiratory Research Group, University of Dundee and Ninewells Hospital and Medical School, Dundee DD1 9SY, UK.
authors.forename: Colin
authors.initials: C
authors.lastname: Murray
authors.forename: Arlene
authors.initials: A
authors.lastname: Shaw
authors.forename: Matthew
authors.initials: M
authors.lastname: Lloyd
authors.forename: Robin P
authors.initials: RP
authors.lastname: Smith
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Fardon
authors.forename: Stuart
authors.initials: S
authors.lastname: Schembri
authors.forename: James D
authors.initials: JD
authors.lastname: Chalmers
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D061345:Early Medical Intervention / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000175:diagnosis* / Q000188:drug therapy*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents
keywords: COPD; LRTIs; asthma; pneumonia; side effects