Details

Autor(en) / Beteiligte

• SETO, WING‐HONG
• CHING, TAI‐YIN
• KOU, MAYBELLE
• CHIANG, SAU‐CHU
• LAUDER, IAN J.
• KUMANA, CYRUS R.

Titel

Hospital antibiotic prescribing successfully modified by ‘immediate concurrent feedback’

Ist Teil von

• British journal of clinical pharmacology, 1996-03, Vol.41 (3), p.229-234

Ort / Verlag

Oxford, UK: Blackwell Publishing Ltd

Erscheinungsjahr

1996

Quelle

Elektronische Zeitschriftenbibliothek (Open access)

Beschreibungen/Notizen

• 1 To determine the effectiveness of ongoing immediate concurrent feedback (ICF) in minimizing ‘inappropriate’ sultamicillin or co‐amoxiclav prescribing via the parenteral route (i.e. when the oral route was accessible and not contraindicated), a prospective controlled audit was carried out on hospital inpatients over a 20 month period. 2 After an education programme to promote oral rather than unnecessary intravenous (i.v.) use of sultamicillin, co‐amoxiclav and certain other drugs, an ongoing ICF strategy was instituted. 3 ICF entailed issue of memos on the following day to prescribers of i.v. sultamicillin or co‐amoxiclav for inpatients in whom this route was deemed ‘inappropriate’, by a specially trained nurse using strict objective criteria. The memos recommended oral prescribing (particularly of co‐amoxiclav, currently the less expensive alternative). 4 After starting ICF, there were consistent, clinically and statistically significant reductions in the monthly proportions of (i) admissions prescribed i.v. sultamicillin or co‐amoxiclav (38%P < 0.001), (ii) those in whom the route was ‘inappropriate’ (75%, P < 0.001), and (iii) corresponding ratios of i.v./oral usage and expenditure, oral sultamicillin/co‐amoxiclav usage and expenditure, as well as total and per admission expenditure on i.v. forms (> 43%, P < 0.01). 5 For i.v. cefuroxime (for which there was no ICF) and its oral counterpart cefuroxime‐axetil, there were no comparable changes in usage or expenditure. 6 This simple, ongoing ICF strategy was effective and well accepted; estimated net monthly savings being HK$26–30,000.