Background and Importance Optimisation of antibiotic (ATB) administration is vital for improving infection treatment effectiveness. An ATB stewardship programme can help clinicians rationalise ATB prescribing. There is no simple and effective tool. Last year we conducted an adherence audit with the local guidelines (LG).

Aim and Objectives This study aimed to review the adherence of clinicians to LG in terms of ATB prescribing and administration.

Material and Methods Single-centre prospective audit for prescribed ATB treatment in at least 50 inpatients admitted to the university hospital with ATB initiation within the first 48 hours of admission. Adherence to LG for ATB was assessed using the adopted audit tool.¹ The patient selection was generated from the hospital’s electronic prescribing system based on emergency department admission and subsequent hospitalisation and ATC code for ATB prescribed within 48 hours. Adherence was assessed as full compliance with LG. Partial adherence was attributed when minor deviation from LG occurred. Nonadherence was defined as an incorrect choice of ATB.

Results During the audited period, there were 1,842 new admissions and ATB were initiated within 48 hours in 478 inpatients (26%). A total of 74 patients with 117 ATB agents were audited and 77 indications for newly prescribed ATB therapy were found. For 46 indications (59.7%) ATB was given in an indication that is included in available LG. The overall adherence to ATB LG was observed in 33 indications (i.e. 71.7% of 46). Partial adherence was found in 11 indications (23.9%). Non-adherence was shown in two indications (4.3%). These involved ATB for surgical prophylaxis. Out of 117 ATB, there was 72% adherence with LG. Incorrect administration of ATB were the most common reasons for partial adherence (21%).

Conclusion and Relevance We found that adherence in 72% of prescribed ATB agents with recommended practices is considered a satisfactory outcome. The audit results were presented to management and shall be repeated in future.

References and/or Acknowledgements 1. Hood G, et al. Measuring appropriate antibiotic prescribing in acute hospitals: development of a national audit tool through a delphi consensus. Antibiotics (Basel). 2019 Apr 29;8(2):49.

This study was supported by Charles University grant SVV 260 665.

Conflict of Interest No conflict of interest.