Abstract
AbstractImportance: Extensive use of antibiotics requiring dose-monitoring and weight-based prescribing can reduce compliance, risking morbidity, and mortality from sepsis. Objective: To determine if gentamicin was being prescribed according to recommendations in the British National Formulary and trust guidelines. Methods: All patients prescribed gentamicin in a one-month period on electronic prescribing were included. Data comprised demographics, admission specialty, dosing regime prescribed, number of doses received, actual dose, and recorded reasons for non-administration. Results: 374 patients were prescribed gentamicin over one month. 223 were prescribed stat doses (207 received, 16 not given; 93% compliance). The remaining 151 patients were on multidose prescriptions, between 3 and 7 doses. 25 received zero doses, 41 a single dose, 50 patients received two doses, and 35 received three doses or greater (23% compliance with guidelines). Conclusion: Antibiotics are essential in treating and preventing...
Highlights
Hospital medicine is increasingly being driven by evidence derived from research and a move away from doing things because “we have always done it this way”
This paper looks at a hospital guideline incorporating gentamicin into the care of patients with sepsis and demonstrates that the practicality of measuring blood levels, ensuring the dose is corrected for the patients weight and the narrow therapeutic window of this drug result in non-compliance with the prescription
This paper looks at a hospital guideline incorporating gentamicin into the care of patients with sepsis and demonstrates that the practicality of measuring blood levels, ensuring the dose is corrected for the patients weight and the narrow therapeutic window of this drug resulted in non-compliance with the prescription
Summary
Hospital medicine is increasingly being driven by evidence derived from research and a move away from doing things because “we have always done it this way”. This paper looks at a hospital guideline incorporating gentamicin (a broad spectrum antibiotic) into the care of patients with sepsis and demonstrates that the practicality of measuring blood levels, ensuring the dose is corrected for the patients weight and the narrow therapeutic window of this drug resulted in non-compliance with the prescription. This can lead to patient safety issues. It is hoped that this paper will encourage clinicians to look closely at guidelines and identify the pitfalls that result in failure of treatment This can allow us to implement change and close the gap between evidence-based medicine and daily clinical practice
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