Details:

Alternative Title:
MMWR Morb Mortal Wkly Rep
Personal Author:
Fridkin, Scott ; Baggs, James ; Fagan, Ryan ; Magill, Shelley ; Pollack, Lori A. ; ... More +
Fridkin, Scott ; Baggs, James ; Fagan, Ryan ; Magill, Shelley ; Pollack, Lori A. ; Malpiedi, Paul ; Slayton, Rachel ; Khader, Karim ; Rubin, Michael A. ; Jones, Makoto ; Samore, Matthew H. ; Dumyati, Ghinwa ; Dodds-Ashley, Elizabeth ; Meek, James ; Yousey-Hindes, Kimberly ; Jernigan, John ; Shehab, Nadine ; Herrera, Rosa ; McDonald, L. Clifford ; Schneider, Amy ; Srinivasan, Arjun Less -
Description:
Background

Antibiotics are essential to effectively treat many hospitalized patients. However, when antibiotics are prescribed incorrectly, they offer little benefit to patients and potentially expose them to risks for complications, including Clostridium difficile infection (CDI) and antibiotic-resistant infections. Information is needed on the frequency of incorrect prescribing in hospitals and how improved prescribing will benefit patients.

Methods

A national administrative database (MarketScan Hospital Drug Database) and CDC’s Emerging Infections Program (EIP) data were analyzed to assess the potential for improvement of inpatient antibiotic prescribing. Variability in days of therapy for selected antibiotics reported to the National Healthcare Safety Network (NHSN) antimicrobial use option was computed. The impact of reducing inpatient antibiotic exposure on incidence of CDI was modeled using data from two U.S. hospitals.

Results

In 2010, 55.7% of patients discharged from 323 hospitals received antibiotics during their hospitalization. EIP reviewed patients’ records from 183 hospitals to describe inpatient antibiotic use; antibiotic prescribing potentially could be improved in 37.2% of the most common prescription scenarios reviewed. There were threefold differences in usage rates among 26 medical/surgical wards reporting to NHSN. Models estimate that the total direct and indirect effects from a 30% reduction in use of broad-spectrum antibiotics will result in a 26% reduction in CDI.

Conclusions

Antibiotic prescribing for inpatients is common, and there is ample opportunity to improve use and patient safety by reducing incorrect antibiotic prescribing.

Implications for Public Health

Hospital administrators and health-care providers can reduce potential harm and risk for antibiotic resistance by implementing formal programs to improve antibiotic prescribing in hospitals.


Subject:
[+]
Anti-Bacterial Agents Clostridium Difficile Databases, Factual Drug Resistance, Bacterial Enterocolitis, Pseudomembranous Hospitalization Humans Patient Safety Practice Patterns, Physicians' Safety Management
Source:
MMWR Morb Mortal Wkly Rep. 2014; 63(9):194-200.
Pubmed ID:
24598596
Pubmed Central ID:
PMC4584728
Document Type:
Journal Article
Place as Subject:
United States
Collection(s):
Morbidity and Mortality Weekly Report (MMWR)
Main Document Checksum:
[+]
urn:sha256:19c9023846b52de0e8f0d422f25ee972be7d93d1a2dd40c0123c65c79ed91bbb
Download URL:
https://stacks.cdc.gov/view/cdc/54828/cdc_54828_DS1.pdf
File Type:

Supporting Files

• 	194-200.nxml	xml
  	194-200f1.gif	gif
  	194-200f1.jpg	jpeg
  	194-200f2.gif	gif
  	194-200f2.jpg	jpeg

More +