Outcome assessment of intervention on appropriateness of antibiotic use among geriatric patients: A prospective interventional study from a tertiary care referral hospital

Abstract

ObjectiveTo assess the inappropriate use of antibiotics in geriatric patients and to assess the impact of clinical pharmacist intervention in reducing the inappropriate use of antibiotics. MethodologyA prospective intervention study of 12 months duration was conducted among 180 geriatric patients who were on treatment with antibiotics for more than 2 days. The outcome measures were compliance with Gyssens criteria and National guidelines for antimicrobial use 1.0(2016). Reason for inappropriateness and quality indicators were also assessed to optimize the antibiotic use and to develop adult traffic light signal for antibiotics. ResultsThe mean stay duration was found to be 7.52 ± 4.47 days, reduced to 4.93 ± 1.72 days in after intervention. Most of indication for antibiotics was respiratory tract infections (30.6%). In the pre intervention, 70% antibiotic therapy proved inappropriate which reduced to 48.8% inappropriateness in the post intervention (p = 0.004). Most common reason given for inappropriateness was wrong drug duration (pre: 41.2%, post: 27.8%). There was a poor compliance with the national guidelines for antibiotic use in the pre intervention (15%) which increased to 25.6% in post intervention. Most of the therapy was given prophylactically and only 30.55% ordered bacteriological test before starting treatment. ConclusionThe study concluded that prescribing patterns do not comply with the recommended standards of care. Since the intervention has a positive impact on inappropriateness the hospital should develop a system to monitor and regulate the use of antibiotics in geriatrics to promote the rational use of antibiotics.