engleski

Assessment of adherence to printed guidelines for antimicrobial drug use in a university hospital

Objectives were to assess the quality of antimicrobial prescribing and the level of adherence to the guidelines in the Department of Medicine at a university hospital. A point- prevalence survey was conducted between September 2008 and May 2011 at four selected time points. General and relevant clinical data of each patient receiving antibiotic treatment were recorded. The necessity of antimicrobial treatment was assessed according to a scoring system based on the presence of signs and symptoms of an infection. The antibiotic use was judged according to Hospital Guidelines for Antimicrobial Drug Use published in December 2008. The percentage of patients receiving antimicrobials varied from 30.8% (N =73) (September 2008) to 25.1% (N = 60) (May 2011). At the first time point 37.3% (N = 25) of patients received antimicrobial therapy evaluated as questionable, significantly more often compared to other time points (p<0.01). Level of adherence to Guidelines varied between 35.0% (April 2009) and 50.0% (May 2011). The highest level of non-compliance with the Guidelines was recorded when prescribing cefuroxime, ceftriaxone and ciprofloxacin. Our study demonstrated a continuous overuse of broad-spectrum antibiotics. A decrease in unjustified antibiotic use and an increase in treatments based on susceptibility testing were noted in the periods when the Guidelines were in use confirming that guidelines for antimicrobial treatment represent a valuable part of antimicrobial stewardship programs.

antimicrobials ; prescribing ; guidelines ; hospital ; point-prevalence survey

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