Day 10 post-prescription audit optimizes antibiotic therapy in patients with bloodstream infections

Rita Murri, C. Palazzolo, F. Giovannenze*, F. Taccari, M. Camici, T. Spanu, Brunella Posteraro, Maurizio Sanguinetti, R. Cauda, M. Fantoni

*Autore corrispondente per questo lavoro

Risultato della ricerca: Contributo in rivistaArticolo in rivista

Abstract

This study aimed to investigate the clinical and organizational impact of an active re-evaluation (on day 10) of patients on antibiotic treatment diagnosed with bloodstream infections (BSIs). A prospective, single center, pre-post quasi-experimental study was performed. Patients were enrolled at the time of microbial BSI confirmation. In the pre-intervention phase (August 2014–August 2015), clinical status and antibiotic regimen were re-evaluated at day 3. In the intervention phase (January 2016–January 2017), clinical status and antibiotic regimen were re-evaluated at day 3 and day 10. Primary outcomes were rate of optimal therapy, duration of antibiotic therapy, length of hospitalization, and 30-day mortality. A total of 632 patients were enrolled (pre-intervention period, n = 303; intervention period, n = 329). Average duration of therapy reduced from 18.1 days (standard deviation (SD), 11.4) in the pre-intervention period to 16.8 days (SD, 12.7) in the intervention period (p < 0.001). Similarly, average length of hospitalization decreased from 24.1 days (SD, 20.8) to 20.6 days (SD, 17.7) (p = 0.001). No inter-group difference was found for the rate of 30-day mortality. In patients with BSI, re-evaluation of clinical status and antibiotic regimen at day 3 and 10 after microbiological diagnosis was correlated with a reduction in the duration of antibiotic therapy and hospital stay. The intervention is simple and has a low impact on overall costs.
Lingua originaleEnglish
pagine (da-a)1-12
Numero di pagine12
RivistaAntibiotics
Volume9
Numero di pubblicazione8
DOI
Stato di pubblicazionePubblicato - 2020

All Science Journal Classification (ASJC) codes

  • ???subjectarea.asjc.2400.2404???
  • ???subjectarea.asjc.1300.1303???
  • ???subjectarea.asjc.3000.3000???
  • ???subjectarea.asjc.2700.2726???
  • ???subjectarea.asjc.2700.2725???
  • ???subjectarea.asjc.2700.2736???

Keywords

  • Antimicrobial stewardship
  • Bacteremia
  • Medical audit

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