Failure to implement hospital antimicrobial prescribing guidelines: experience in another UK academic centre.
نویسندگان
چکیده
Sir, Ali et al. recently reported poor compliance with prescribing guidelines for the treatment of community-acquired pneumonia and urinary tract infection (UTI) in two UK academic hospital groups. We would like to report the results of a prospective audit of the management of UTI in our Trust, which is also an academic centre. The aim of the audit was to determine whether physicians were managing UTIs in adult inpatients according to the Trust guideline. The guideline set out criteria for allocation of patients into clinical categories (uncomplicated/complicated UTI), and advised on the interpretation of the point of care testing (POCT), when to send a sample for culture, and choice and duration of empirical antibiotic therapy based on the local epidemiology of antibiotic resistance in Escherichia coli. It was written by microbiologists, infectious disease physicians and pharmacists. It was approved by the Trust’s Medicines Advisory Committee, and had been distributed in paper format to all Consultants about a year before the audit. It was available to all staff in electronic format via the hospital intranet. Data were collected prospectively for 100 consecutive adult acute general medical patients with a clinical diagnosis (intention to treat) of UTI. These were identified by daily ward review by one of the authors and by monitoring urine samples sent to the laboratory for culture. Of 70 female and 30 male patients, 51 had community-acquired UTI (diagnosis made within 48 h of admission) and 49 were hospital acquired. Thirty-one patients had catheter-related UTI (18 female), 64 patients had complicated UTI and 36 had uncomplicated disease.
منابع مشابه
Failure to implement hospital antimicrobial prescribing guidelines: a comparison of two UK academic centres.
BACKGROUND Rational antimicrobial therapy should provide maximum benefit to patients while minimizing the development of resistant microorganisms. OBJECTIVES The aim of this study was to investigate (i) which antimicrobial drugs were chosen by hospital doctors faced with two common infections [community-acquired pneumonia (CAP) and urinary tract infection (UTI)], (ii) whether these choices we...
متن کاملA qualitative study of factors influencing antimicrobial prescribing by non-consultant hospital doctors.
OBJECTIVES To determine the factors that influence non-consultant hospital doctors (NCHDs) in their decision to prescribe antimicrobial agents. METHODS A qualitative study using semi-structured interviews centred on a life grid tracking the medical career of 22 NCHDs employed by a university teaching hospital in the west of Ireland. RESULTS Early in their careers NCHD prescribing is based p...
متن کاملResistance is futile--a conference to promote the rational use of antimicrobials in acute hospitals.
This article reports on the proceedings of a meeting held in London in July 2005 organized by the Specialist Advisory Committee on Antimicrobial Resistance in conjunction with the UK National Prescribing Centre and UK Department of Health. The focus of the meeting was the developing role of the antibiotic pharmacist. The main presentations tackled four aspects of hospital antimicrobial prescrib...
متن کاملIranian Nurses\' Attitudes and Readiness for Nurse Prescribing: A Cross Sectional Study
Abstract Introduction: Since prescribing is a new subject in the nursing profession, it is necessary to assess nurses' attitudes to and readiness for this new responsibility. Objective: This study aimed to investigate nurses' attitudes to and readiness for nurse prescribing in teaching hospitals of Tabriz City, Iran. Materials and Methods: This cross-sectional analytical study was conducted...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
- The Journal of antimicrobial chemotherapy
دوره 59 2 شماره
صفحات -
تاریخ انتشار 2007