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CIDRAP Stewardship / Resistance Scan: Selection list for antibiotic Rx; Antibiotic consumption calculator

Shiloh

Editor, Senior Moderator
Source: http://www.cidrap.umn.edu/news-perspective/2018/06/stewardship-resistance-scan-jun-01-2018


Stewardship / Resistance Scan for Jun 01, 2018
Selection list for antibiotic Rx; Antibiotic consumption calculator

Filed Under:
Antimicrobial Stewardship

[h=3]Evidence-based antibiotic list helps in appropriate prescribing[/h] A Johns Hopkins study has determined that selecting an indication for antibiotics from an evidence-based list as opposed to free-text indications increases the odds that antibiotic agents will be used appropriately, according to a study yesterday in the American Journal of Infection Control.
After drug-specific lists of evidence-based indications were integrated into an electronic health system as an ordering hard-stop, the investigators reviewed 155 antibiotic orders to assess the new system. They found that clinical documentation supported the entered indication in 80% of vancomycin orders, 78% of cefepime orders, and 74% of fluoroquinolone orders, and the clinical appropriateness for three antibiotics were 94%, 100%, and 68%, respectively.
They also determined that, when providers chose indications from the evidence-based list as opposed to choosing "other" and entering free text, antibiotic orders were almost six times more likely to be appropriate but also less likely to match clinical documentation (odds ratio, 0.25).
May 31 Am J Infect Control abstract

[h=3]South Korean study finds a few antibiotics can represent total hospital use[/h] Total antibiotic consumption at a hospital can be represented sufficiently by tracing the use of a few antibiotics, South Korean researchers reported yesterday in a mathematical modeling study in BMC Infectious Diseases.
While tracking antibiotic use at hospitals is the first step in determining the amount of misuse, collecting data on use of all antibiotics can be difficult without an advanced computerized system and dedicated staff. To determine whether the tracking one to three antibiotics could accurately capture overall antibiotic use, the researchers collected data on antibiotic prescriptions from six large Korean university hospitals with good computerized systems from 2004 to 2012. They then built a statistical model in which one to three representative antibiotics are chosen to predict the total antibiotic consumption at the hospital level in 2013.
The researchers found that fluoroquinolones and aminoglycosides were the most representative antibiotics at the six hospitals, followed by beta-lactam/beta-lactamase inhibitors, and fourth-generation and third-generation cephalosporins. The mean production error over 12 months in 2013 with these few antibiotics was only 1% to 3% of the monthly antibiotic consumption.
The researchers say the model could save time and effort surrounding non-essential data collection, allowing medical personnel to concentrate on more important healthcare activities. They suggest hospitals in other countries may follow a similar modeling methodology to find their own representative antibiotics.
May 31 BMC Infect Dis study
 
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