Background The inappropiate use of antibiotics is leading to the appearance of resistance that, along with the decline in the development of new antibacterials, makes some experts talk about a future post-antibiotic period. Approximately between 80% and 90% of antibiotics use occurs in outpatients. It is estimated that about half of the antibiotic prescriptions in outpatients are inappropriate due either to antibiòtic selection, dosage or duration.
Purpose The primary objective of the project is to measure the impact of a multimodal intervention on the use of antibiotics in the emergency department (ED) of a primary care area (PCA).
Material and methods Prospective study with intervention in ED of a PCA (population: 260,517) from January to June 2017. Recorded variables: defined daily dose (DDD) of amoxicillin, amoxicillin/clavulanic, macrolides, quinolones and other antibiotics from January to June 2017. The information was extracted from patients’ medical prescriptions.
Intervention 1) Emergency physicians
a) Commitment: The programme was presented to the head of the ED medical service, emergency physicians and primary care centre directors, through face-to-face sessions. Poster reminders of the project were placed in medical consultations and the ED.
b) Actions directed to improve the prescription of antibiotics: An antimicrobial stewardship guideline was designed with local antimicrobial recommendations.
c) Audit and feedback: Information was provided to emergency physicians, with their antimicrobial consumption rate establishing a comparison between physicians and the ED average.
d) Education and experience: Interactive clinical sessions were held on different pathologies included in the antimicrobial stewardship programme.
Posters and educational brochures for waiting rooms and consultations were designed.
Results From January to June 2017 total antibiotic use was reduced by 14.4% DDD compared to the same period of 2016. A decrease in the main families of antibiotics was observed: 22.42% amoxicillin, 6.89% amoxicillin/clavulanic, 21.96% macrolides, 32.42% quinolones and 1.73% of other antibiotics.
Conclusion The strategy designed to improve the use of antibiotics in the ED of the PCA led to a decrease in antibiotic consumption.
References and/or Acknowledgements No acknowledgements
No conflict of interest
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