Background and importance Shortening the duration of antibiotic treatment is one of the cornerstones to reduce antibiotic pressure and, therefore, the appearance of antimicrobial resistance
Aim and objectives To describe the duration of antibiotic treatment in patients discharged from a short stay hospitalisation unit and to analyse the duration of antibiotic treatment with regards to the current evidence based recommendations.
Material and methods A descriptive, retrospective, cross sectional study was carried out in a short stay hospitalisation unit in January 2020. Patients ≥14 years old with an antibiotic prescription at discharge were included. Data collected were: age, gender, average number of admission days, antibiotic prescribed and antibiotic clinical indication. Data were collected from patients’ electronic health records. Pubmed database review was performed regarding the current evidence based recommendations for optimising the duration of antibiotic treatment.
Results 98 patients were admitted in January 2020; 63 patients met the study inclusion criteria and 40 were men. Average age was 74 years (18–92) and average number of admission days was 3.4 (1–11). 11 (17.5%) patients visited the emergency department or general practice the following month due to an infectious process and 7 of these patients were readmitted. 36 (57%) patients had taken antibiotics within 3 months before the study.
The most common illnesses were community acquired pneumonia (CAP) 16 (25.4%), acute bronchitis (AB) 15 (23.8%), COPD exacerbation 13 (20.6%) and influenza 7 (11.1%). The most common antimicrobials prescribed were: cephalosporins 24 (26.7%), co-amoxiclav 20 (22.2%) and quinolones 17 (18.9%).
Patients with AB were not analysed because there is no optimal duration of antibiotic treatment recommended in the current scientific evidence. The remainder of the patients were analysed (48): 35 were given antibiotics for more days than the recommended evidence (15 CAP, 12 COPD exacerbation, 4 influenza, 4 other infections); 9 patients were given antibiotics as per the recommended duration (3 acute pyelonephritis, 3 influenza, 1 CAP, 1 hospital acquired pneumonia, 1 complicated cystitis); and 4 were given antibiotics for a shorter duration than recommended (1 complicated cystitis, 1 COPD exacerbation, 1 pharyngotonsillitis, 1 acute gastroenteritis).
Conclusion and relevance Nearly 75% of patients had a longer antibiotic course than the recommended evidence. This should be a priority for intervention. It is important to create antibiotic awareness, where ‘shorter is better’ is a ‘prescriber mantra’ as far as the rational use of antibiotics is concerned.
Conflict of interest No conflict of interest
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