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Title

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

Authors
Lutters, M.
Freudiger, H.
Published in Journal of the American Geriatrics Society. 2004, vol. 52, no. 1, p. 112-116
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 AgedAged, 80 and overAnti-Bacterial Agents/*therapeutic useChi-Square DistributionCross-Sectional StudiesDrug Utilization Review*Education, Medical, ContinuingFemaleHospitals, SpecialHospitals, UniversityHumansIntervention StudiesLinear ModelsMalePhysician's Practice Patterns/*statistics & numerical dataRespiratory Tract Infections/*drug therapyStatistics, NonparametricUrinary Tract Infections/*drug therapy
Identifiers
PMID: 14687324
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Research group Epidémiologie et contrôle de la résistance aux antibiotiques (866)
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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 https://archive-ouverte.unige.ch/unige:28144

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Deposited on : 2013-05-28

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