An audit of antimicrobial treatment of lower respiratory and urinary tract infections in a hospital setting

Hedvig Maripuu, Mamoon A. Aldeyab, Mary P. Kearney, James C. McElnay, Geraldine Conlon, Fidelma A. Magee, Michael G. Scott

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objectives To audit the quality of treatment of lower respiratory tract infections (LRTIs) and urinary tract infections (UTIs) and to identify targets for antibiotic stewardship. Methods The audit involved collecting data on admitted patients, who were diagnosed with LRTIs or UTIs and subsequently received antibiotic treatment (January 2009-April 2009). Key findings The percentage adherence rate for hospital antibiotic policy was 68.6% (24/35). Documentation of the CURB-65 score was found in 80% (16/20) of the patients' clinical notes, for which 46.2% (6/13) of patients were treated according to their CURB- 65 score. The percentages of delayed and missed doses for all antibiotics were 21.7% (254/1171) and 8.6% (101/1171), respectively. The percentage of patients switched from intravenous to oral antibiotics in accordance with the policy was 58.5% (31/53). The mean length of stay for patients switched in line with the guidelines was 6.9 days (range: 2-18 days) compared with 13.2 days (range: 4-28 days) for patients treated with intravenous antibiotics >24 h after the intravenous to oral switch criteria were fulfilled; this equates to on average an extra 6.3 days of hospitalisation (p=0.01). Conclusions The study identified a number of targets for quality improvement including adherence to antibiotic policy, documentation of the CURB-65 score in patients' notes and treating patients accordingly, addressing the issue of missed and delayed doses, and maintaining adherence to the hospital intravenous-to-oral antibiotic switch policy. The findings suggest that the quality of antibiotic prescribing could be improved by measuring and addressing such performance indicators.

Original languageEnglish
Pages (from-to)139-144
Number of pages6
JournalEuropean Journal of Hospital Pharmacy
Volume21
Issue number3
DOIs
Publication statusPublished - 17 Jan 2014
Externally publishedYes

Fingerprint

Urinary Tract Infections
Respiratory Tract Infections
Anti-Bacterial Agents
Therapeutics
Documentation
Quality Improvement
Length of Stay
Hospitalization
Guidelines

Cite this

Maripuu, Hedvig ; Aldeyab, Mamoon A. ; Kearney, Mary P. ; McElnay, James C. ; Conlon, Geraldine ; Magee, Fidelma A. ; Scott, Michael G. / An audit of antimicrobial treatment of lower respiratory and urinary tract infections in a hospital setting. In: European Journal of Hospital Pharmacy. 2014 ; Vol. 21, No. 3. pp. 139-144.
@article{2463081573904d8886239f888333e306,
title = "An audit of antimicrobial treatment of lower respiratory and urinary tract infections in a hospital setting",
abstract = "Objectives To audit the quality of treatment of lower respiratory tract infections (LRTIs) and urinary tract infections (UTIs) and to identify targets for antibiotic stewardship. Methods The audit involved collecting data on admitted patients, who were diagnosed with LRTIs or UTIs and subsequently received antibiotic treatment (January 2009-April 2009). Key findings The percentage adherence rate for hospital antibiotic policy was 68.6{\%} (24/35). Documentation of the CURB-65 score was found in 80{\%} (16/20) of the patients' clinical notes, for which 46.2{\%} (6/13) of patients were treated according to their CURB- 65 score. The percentages of delayed and missed doses for all antibiotics were 21.7{\%} (254/1171) and 8.6{\%} (101/1171), respectively. The percentage of patients switched from intravenous to oral antibiotics in accordance with the policy was 58.5{\%} (31/53). The mean length of stay for patients switched in line with the guidelines was 6.9 days (range: 2-18 days) compared with 13.2 days (range: 4-28 days) for patients treated with intravenous antibiotics >24 h after the intravenous to oral switch criteria were fulfilled; this equates to on average an extra 6.3 days of hospitalisation (p=0.01). Conclusions The study identified a number of targets for quality improvement including adherence to antibiotic policy, documentation of the CURB-65 score in patients' notes and treating patients accordingly, addressing the issue of missed and delayed doses, and maintaining adherence to the hospital intravenous-to-oral antibiotic switch policy. The findings suggest that the quality of antibiotic prescribing could be improved by measuring and addressing such performance indicators.",
author = "Hedvig Maripuu and Aldeyab, {Mamoon A.} and Kearney, {Mary P.} and McElnay, {James C.} and Geraldine Conlon and Magee, {Fidelma A.} and Scott, {Michael G.}",
year = "2014",
month = "1",
day = "17",
doi = "10.1136/ejhpharm-2013-000394",
language = "English",
volume = "21",
pages = "139--144",
journal = "European Journal of Hospital Pharmacy",
issn = "2047-9956",
publisher = "European Association of Hospital Pharmacists (EAHP)",
number = "3",

}

An audit of antimicrobial treatment of lower respiratory and urinary tract infections in a hospital setting. / Maripuu, Hedvig; Aldeyab, Mamoon A.; Kearney, Mary P.; McElnay, James C.; Conlon, Geraldine; Magee, Fidelma A.; Scott, Michael G.

In: European Journal of Hospital Pharmacy, Vol. 21, No. 3, 17.01.2014, p. 139-144.

Research output: Contribution to journalArticle

TY - JOUR

T1 - An audit of antimicrobial treatment of lower respiratory and urinary tract infections in a hospital setting

AU - Maripuu, Hedvig

AU - Aldeyab, Mamoon A.

AU - Kearney, Mary P.

AU - McElnay, James C.

AU - Conlon, Geraldine

AU - Magee, Fidelma A.

AU - Scott, Michael G.

PY - 2014/1/17

Y1 - 2014/1/17

N2 - Objectives To audit the quality of treatment of lower respiratory tract infections (LRTIs) and urinary tract infections (UTIs) and to identify targets for antibiotic stewardship. Methods The audit involved collecting data on admitted patients, who were diagnosed with LRTIs or UTIs and subsequently received antibiotic treatment (January 2009-April 2009). Key findings The percentage adherence rate for hospital antibiotic policy was 68.6% (24/35). Documentation of the CURB-65 score was found in 80% (16/20) of the patients' clinical notes, for which 46.2% (6/13) of patients were treated according to their CURB- 65 score. The percentages of delayed and missed doses for all antibiotics were 21.7% (254/1171) and 8.6% (101/1171), respectively. The percentage of patients switched from intravenous to oral antibiotics in accordance with the policy was 58.5% (31/53). The mean length of stay for patients switched in line with the guidelines was 6.9 days (range: 2-18 days) compared with 13.2 days (range: 4-28 days) for patients treated with intravenous antibiotics >24 h after the intravenous to oral switch criteria were fulfilled; this equates to on average an extra 6.3 days of hospitalisation (p=0.01). Conclusions The study identified a number of targets for quality improvement including adherence to antibiotic policy, documentation of the CURB-65 score in patients' notes and treating patients accordingly, addressing the issue of missed and delayed doses, and maintaining adherence to the hospital intravenous-to-oral antibiotic switch policy. The findings suggest that the quality of antibiotic prescribing could be improved by measuring and addressing such performance indicators.

AB - Objectives To audit the quality of treatment of lower respiratory tract infections (LRTIs) and urinary tract infections (UTIs) and to identify targets for antibiotic stewardship. Methods The audit involved collecting data on admitted patients, who were diagnosed with LRTIs or UTIs and subsequently received antibiotic treatment (January 2009-April 2009). Key findings The percentage adherence rate for hospital antibiotic policy was 68.6% (24/35). Documentation of the CURB-65 score was found in 80% (16/20) of the patients' clinical notes, for which 46.2% (6/13) of patients were treated according to their CURB- 65 score. The percentages of delayed and missed doses for all antibiotics were 21.7% (254/1171) and 8.6% (101/1171), respectively. The percentage of patients switched from intravenous to oral antibiotics in accordance with the policy was 58.5% (31/53). The mean length of stay for patients switched in line with the guidelines was 6.9 days (range: 2-18 days) compared with 13.2 days (range: 4-28 days) for patients treated with intravenous antibiotics >24 h after the intravenous to oral switch criteria were fulfilled; this equates to on average an extra 6.3 days of hospitalisation (p=0.01). Conclusions The study identified a number of targets for quality improvement including adherence to antibiotic policy, documentation of the CURB-65 score in patients' notes and treating patients accordingly, addressing the issue of missed and delayed doses, and maintaining adherence to the hospital intravenous-to-oral antibiotic switch policy. The findings suggest that the quality of antibiotic prescribing could be improved by measuring and addressing such performance indicators.

UR - http://www.scopus.com/inward/record.url?scp=84901265158&partnerID=8YFLogxK

U2 - 10.1136/ejhpharm-2013-000394

DO - 10.1136/ejhpharm-2013-000394

M3 - Article

VL - 21

SP - 139

EP - 144

JO - European Journal of Hospital Pharmacy

JF - European Journal of Hospital Pharmacy

SN - 2047-9956

IS - 3

ER -