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dc.contributor.authorHøgli, June Utnes
dc.contributor.authorGarcia, Beate Hennie
dc.contributor.authorSkjold, frode
dc.contributor.authorSkogen, Vegard
dc.contributor.authorSmåbrekke, Lars
dc.date.accessioned2017-03-01T11:45:18Z
dc.date.available2017-03-01T11:45:18Z
dc.date.issued2016-02-27
dc.description.abstractBackground:<br> Appropriate antibiotic prescribing is associated with favourable levels of antimicrobial resistance (AMR) and clinical outcomes. Most intervention studies on antibiotic prescribing originate from settings with high level of AMR. In a Norwegian hospital setting with low level of AMR, the literature on interventions for promoting guideline-recommended antibiotic prescribing in hospital is scarce and requested. Preliminary studies have shown improvement potentials regarding antibiotic prescribing according to guidelines. We aimed to promote appropriate antibiotic prescribing in patients with community-acquired pneumonia (CAP) and acute exacerbations of chronic obstructive pulmonary disease (AECOPD) at a respiratory medicine department in a Norwegian University hospital. Our specific objectives were to increase prescribing of appropriate empirical antibiotics, reduce high-dose benzylpenicillin and reduce total treatment duration.<br> Methods:<br> We performed an audit and feedback intervention study, combined with distribution of a recently published pocket version of the national clinical practice guideline. We included patients discharged with CAP or AECOPD and prescribed antibiotics during hospital stay, and excluded those presenting with aspiration, nosocomial infection and co-infections. The pre- and post-intervention period was 9 and 6 months, respectively. Feedback was provided orally to the department physicians at an internal-educational meeting. To explore the effect of the intervention on appropriate empirical antibiotics and mean total treatment duration we applied before-after analysis (Student’s t-test) and interrupted time series (ITS). We used Pearson’s χ2 to compare dose changes.<br> Results:<br> In the pre-and post-intervention period we included 253 and 155 patients, respectively. Following the intervention, overall mean prescribing of appropriate empirical antibiotics increased from 61.7 to 83.8 % (P < 0.001), overall mean total treatment duration decreased from 11.2 to 10.4 days (P = 0.015), and prescribing of high-dose benzylpenicillin decreased from 48.8 to 38.6 % (P = 0.125). With ITS we found that six months post-intervention, the effect on appropriate empirical antibiotic prescribing had increased and sustained, while the effect on treatment duration was at pre-intervention level.<br> Conclusion:<br> The combination of audit and feedback plus distribution of a pocket version of guideline recommendations led to a substantial increase in prescribing of appropriate empirical antibiotics, which is important due to favourable effect on AMR and clinical outcomes.<br> Keywords:<br> Community-acquired pneumonia Acute exacerbation of chronic pulmonary disease Intervention Antibiotic Audit and feedback Norwayen_US
dc.descriptionSource: <a href=http://dx.doi.org/10.1186/s12879-016-1426-1>doi: 10.1186/s12879-016-1426-1</a>en_US
dc.identifier.citationHøgli, J. et al. An audit and feedback intervention study increased adherence to antibiotic prescribing guidelines at a Norwegian hospital. BMC Infectious Diseases. 2016;16(1)en_US
dc.identifier.cristinIDFRIDAID 1360807
dc.identifier.doi10.1186/s12879-016-1426-1
dc.identifier.issn1471-2334
dc.identifier.urihttps://hdl.handle.net/10037/10401
dc.language.isoengen_US
dc.publisherBioMed Centralen_US
dc.relation.journalBMC Infectious Diseases
dc.rights.accessRightsopenAccessen_US
dc.subjectVDP::Medisinske Fag: 700::Basale medisinske, odontologiske og veterinærmedisinske fag: 710::Klinisk farmakologi: 739en_US
dc.subjectVDP::Medical disciplines: 700::Basic medical, dental and veterinary science disciplines: 710::Clinical pharmacology: 739en_US
dc.titleAn audit and feedback intervention study increased adherence to antibiotic prescribing guidelines at a Norwegian hospitalen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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