en
Scientific article
English

Effect of a comprehensive, multidisciplinary, educational program on the use of antibiotics in a geriatric university hospital

Published inJournal of the American Geriatrics Society, vol. 52, no. 1, p. 112-116
Publication date2004
Abstract

OBJECTIVES: To assess the effect of a comprehensive, educational antibiotic management program designed to improve antibiotic use and reduce treatment costs in elderly patients with suspected urinary or respiratory tract infection. DESIGN: Interventional cohort study with 12 cross-sectional drug utilization reviews of antibiotic use before, during, and after the multifaceted intervention. SETTING: A 304-bed university hospital for geriatric patients. PARTICIPANTS: A total of 3,383 elderly patients. INTERVENTIONS: An educational program including distribution of guidelines on the diagnosis and treatment of urinary and respiratory tract infections; lectures on geriatric infectious diseases; weekly ward rounds for patients with suspected infection; and targeted, individual counseling on diagnosis and antibiotic treatment of infections. MEASUREMENTS: Antibiotic utilization data were collected from the patients' records. Antimicrobial costs were calculated using 1998 hospital wholesale prices. RESULTS: Of 3,383 screened patients, 680 (20%) received at least one antibiotic. During the study period, the mean number of prescribed drugs per patient increased from 5.9 to 7.6 (29%; P<.001). In contrast, a reduction of 15% was observed in the proportion of patients exposed to antibiotic agents (P=.08) and a drop of 26% in the number of antibiotics administered (P<.001). This resulted in a 54% decrease in cumulative daily antibiotic costs. In 83 (75%) of 110 surveyed patients, the guidelines were correctly implemented. The intervention had no measurable negative clinical effect. CONCLUSION: A comprehensive, multifaceted educational program for treating urinary and respiratory tract infections in the elderly was a safe and practical method to change physicians' antibiotic prescribing practice and significantly reduce the consumption and costs of antibiotics in a geriatric hospital.

Keywords
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents/*therapeutic use
  • Chi-Square Distribution
  • Cross-Sectional Studies
  • Drug Utilization Review
  • *Education, Medical, Continuing
  • Female
  • Hospitals, Special
  • Hospitals, University
  • Humans
  • Intervention Studies
  • Linear Models
  • Male
  • Physician's Practice Patterns/*statistics & numerical data
  • Respiratory Tract Infections/*drug therapy
  • Statistics, Nonparametric
  • Urinary Tract Infections/*drug therapy
Citation (ISO format)
LUTTERS, M. et al. Effect of a comprehensive, multidisciplinary, educational program on the use of antibiotics in a geriatric university hospital. In: Journal of the American Geriatrics Society, 2004, vol. 52, n° 1, p. 112–116. doi: 10.1111/j.1532-5415.2004.52019.x
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ISSN of the journal0002-8614
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