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Multifaceted intervention for improving antimicrobial prescription at discharge in the emergency department

Published online by Cambridge University Press:  05 February 2021

Yasuaki Tagashira*
Affiliation:
Division of Infectious Diseases, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan Department of Microbiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
Manaka Goto
Affiliation:
Division of Infectious Diseases, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
Reiko Kondo
Affiliation:
Division of Infectious Diseases, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
Hitoshi Honda
Affiliation:
Division of Infectious Diseases, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
*
Author for correspondence: Yasuaki Tagashira E-mail: [email protected]

Abstract

The frequent prescription of antimicrobials, such as at discharge from the emergency department, calls for optimizing this practice through modifying physicians’ prescribing behavior. A 1-year, multifaceted intervention implemented in an emergency department decreased the mean monthly antimicrobial prescription rate at discharge and increased the proportion of appropriate prescriptions.

Type
Concise Communication
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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References

Fleming-Dutra, KE, Hersh, AL, Shapiro, DJ, et al. Prevalence of inappropriate antibiotic prescriptions among US ambulatory care visits, 2010–2011. JAMA 2016;315:18641873.CrossRefGoogle ScholarPubMed
Hersh, AL, King, LM, Shapiro, DJ, Hicks, LA, Fleming-Dutra, KE. Unnecessary antibiotic prescribing in US ambulatory care settings, 2010–2015. Clin Infect Dis 2020. doi: 10.1093/cid/ciaa667.CrossRefGoogle Scholar
Tagashira, Y, Yamane, N, Miyahara, S, et al. Misuse of discharge antimicrobial prescription in the emergency department: an observational study at a tertiary care center. Open Forum Infect Dis 2019;6:ofz016.CrossRefGoogle Scholar
Shehab, N, Lovegrove, MC, Geller, AI, Rose, KO, Weidle, NJ, Budnitz, DS. US Emergency department visits for outpatient adverse drug events, 2013–2014. JAMA 2016;316:21152125.CrossRefGoogle ScholarPubMed
Dantes, R, Mu, Y, Hicks, LA, et al. Association between outpatient antibiotic prescribing practices and community-associated Clostridium difficile infection. Open Forum Infect Dis 2015;2:ofv113.CrossRefGoogle ScholarPubMed
Seppala, H, Klaukka, T, Vuopio-Varkila, J, et al. The effect of changes in the consumption of macrolide antibiotics on erythromycin resistance in group A streptococci in Finland. Finnish Study Group for Antimicrobial Resistance. N Engl J Med 1997;337:441446.CrossRefGoogle Scholar
Antibiotic resistance threats in the United States, 2019. Centers for Disease Control and Prevention website. https://www.cdc.gov/drugresistance/pdf/threats-report/2019-ar-threats-report-508.pdf. Accessed December 2, 2020.Google Scholar
Schmidt, ML, Spencer, MD, Davidson, LE. Patient, provider, and practice characteristics associated with inappropriate antimicrobial prescribing in ambulatory practices. Infect Control Hosp Epidemiol 2018;39:307315.CrossRefGoogle ScholarPubMed
Spivak, ES, Cosgrove, SE, Srinivasan, A. Measuring appropriate antimicrobial use: attempts at opening the black box. Clin Infect Dis 2016;63:16391644.Google ScholarPubMed
Sato, D, Goto, T, Uda, K, Kumazawa, R, Matsui, H, Yasunaga, H. Impact of national guidelines for antimicrobial stewardship to reduce antibiotic use in upper respiratory tract infection and gastroenteritis. Infect Control Hosp Epidemiol 2020. doi: 10.1017/ice.2020.427.CrossRefGoogle Scholar
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