Proportion Of Antibiotics Research Articles

A controlled Intervention Study: Comparison of Intervention on the Antibiotic Prophylaxis of Three Clean Surgeries in Chinese Tertiary Hospitals

A controlled intervention study was to promote rational antibiotic prophylaxis in clean surgeries in Chinese tertiary hospitals from 2008 to 2009. The effect of the intervention was measured and compared before and after intervention (intervention group, IG, including twelve hospitals), and compared with the control group (CG, including 164 tertiary hospitals distributed in 31 provinces). There were a total of 3961 and 657 cases identified in IG & CG for the study. Comparing the changes of IG with CG following the 3rd intervention, the proportion of antibiotics use without indication decreased from 61.9% (IG) & 84.4% (CG) (χ2 test, P χ2 test, P > 0.05); the rationality scores increased from 55.4 (IG) & 57.6 (CG) (t test, P > 0.05) to 77.0 (IG) & 64.3 (CG) (t test, P

Root Cause Analysis and Subsequent Intervention to Improve First Dose Antibiotic Turnaround Time for Hospitalized Pediatric Patients

Antibiotic timing is used as a quality standard for hospital accreditation and is an important quality measure. The study aim was to identify barriers in the process of first dose antibiotic administration on the pediatric floors at a tertiary healthcare center and carry out and test an intervention to improve turnaround time to less than one hour. We conducted a quasi-experimental pre-post study of hospitalized pediatric patients up to 18 years of age initiated on intravenous antibiotics. Every order for a first dose intravenous antibiotic was assessed on all pediatric floors (10/2008). Orders that did not meet the overall turnaround time goal of ≤ 1 hour were identified. A root cause analysis (RCA) was performed to identify reasons for delayed antibiotic administration. Barriers identified in the RCA were used to develop interventions (03/2009) to improve compliance, and the proportion of orders that met the goal was compared pre- (10/2008-02/2009) and post-intervention (04/2009-05/2009). During the pre-intervention assessment period, 32 out of 46 total physician orders for a first dose intravenous antibiotic did not meet the one-hour overall turnaround goal. A main reason for delay was failure to label antibiotic orders as first dose. We designed an intervention that included antibiotic audits and individualized feedback to prescribers. The mean ± SD time from the written physician order to drug administration was 228 ± 58 minutes; timing improved to 55 ± 4 minutes after the intervention. The proportion of antibiotics administered within one hour improved from 42.2% to 63% (p=0.0015). We identified system barriers associated with delayed antibiotic administration. Antibiotic timing was improved after continued surveillance and individualized feedback to providers.

The Regulation of Infection

The Regulation of Infection

A continuous quality improvement initiative reduces inappropriate prescribing of prophylactic antibiotics for endoscopic procedures

OBJECTIVE: Despite the availability of guidelines, most gastroenterologists do not administer prophylactic antibiotics appropriately to patients having endoscopic procedures. In 1994 we recognized that in our endoscopy unit, many patients were receiving antibiotics without proper indication. We devised a continuous quality improvement initiative to analyze and improve this problem. METHODS: Divisional guidelines for the appropriate administration of prophylactic antibiotics for endoscopy were drawn up in 1995. By retrospective analysis of our comprehensive endoscopy database we compared the rate of prophylactic antibiotic administration, and the proportion of antibiotics that were indicated before and after adoption of the divisional guidelines. RESULTS: A total of 1427 endoscopic procedures were done during a 6-month period in 1994 (before adoption of guidelines). Of these, 55 (3.85%) received antibiotics. In a 6-month period in 1996 after adoption of guidelines, 1452 procedures were performed and 29 of these (1.99%) received antibiotics. The odds ratio for receiving antibiotics appropriately in 1996, compared with 1994, was 3.4 (χ 2 p = 0.016). Given an annual volume of 2900 procedures in our endoscopy unit, approximately 54 patients will avoid unnecessary antibiotics, yielding a cost saving of $1128 per year. CONCLUSIONS: A divisional continuous quality improvement initiative on antibiotic prophylaxis for endoscopy significantly reduced the proportion of patients receiving antibiotics unnecessarily. This quality improvement initiative enhanced the quality of care for patients having endoscopy and yielded a small cost saving. These improvements were achieved with minimal effort and cost to the division.

A continuous quality improvement initiative reduces inappropriate prescribing of prophylactic antibiotics for endoscopic procedures.

Despite the availability of guidelines, most gastroenterologists do not administer prophylactic antibiotics appropriately to patients having endoscopic procedures. In 1994 we recognized that in our endoscopy unit, many patients were receiving antibiotics without proper indication. We devised a continuous quality improvement initiative to analyze and improve this problem. Divisional guidelines for the appropriate administration of prophylactic antibiotics for endoscopy were drawn up in 1995. By retrospective analysis of our comprehensive endoscopy database we compared the rate of prophylactic antibiotic administration, and the proportion of antibiotics that were indicated before and after adoption of the divisional guidelines. A total of 1427 endoscopic procedures were done during a 6-month period in 1994 (before adoption of guidelines). Of these, 55 (3.85%) received antibiotics. In a 6-month period in 1996 after adoption of guidelines, 1452 procedures were performed and 29 of these (1.99%) received antibiotics. The odds ratio for receiving antibiotics appropriately in 1996, compared with 1994, was 3.4 (chi2 p = 0.016). Given an annual volume of 2900 procedures in our endoscopy unit, approximately 54 patients will avoid unnecessary antibiotics, yielding a cost saving of $1128 per year. A divisional continuous quality improvement initiative on antibiotic prophylaxis for endoscopy significantly reduced the proportion of patients receiving antibiotics unnecessarily. This quality improvement initiative enhanced the quality of care for patients having endoscopy and yielded a small cost saving. These improvements were achieved with minimal effort and cost to the division.