Improving antibiotic stewardship in an acute medical unit

Abstract

Antibiotic resistance is related to the incorrect/inappropriate use of antibiotics.In 2019, there were nearly 5 million deaths associated with bacterialantimicrobial resistance across 204 countries. There has been anincrease in antibiotic prescription within secondary care by about 4.8%since the COVID-19 pandemic. Appropriate use of antibiotics reducesthe risk of antibiotic resistance and attendant morbidity and mortality.The aim was to improve compliance with trust guidelines when prescribingantibiotics as well as documentation of antibiotic indication andreview date.A retrospective study was conducted for patients admitted to AMUin October ‘22 who had been prescribed antibiotics as part of theirmanagement. Clinical information regarding the appropriateness of theantibiotic and documentation of the indication and review by date wasobtained. Interventions used were one-on-one teaching, group teaching,as well as posters put up throughout the department. We worked withtrust pharmacy and QI department and then completed the Plan-Do-Study-Act cycle.Post intervention, 12% of the patients admitted had received antibioticsfor non-infectious illness compared with 26% in the 1st cycle, 48%had antibiotics prescribed according to micro-guide, compared with41.6% pre-intervention, and 5% had indications documented on EPMA,compared with none previously. These were published at the trust SharedLearning Bulletin. Overall, there has been a positive change in attitudetowards the prescription of antibiotics, with more attention paid to indicationand review-by date.