Does an educational session with an infectious diseases physician reduce the use of inappropriate antibiotic therapy for inpatients with positive urine culture results? A controlled before-and-after study.

In this controlled before-and-after study involving 19 departments in a university-affiliated hospital, a single 1-hour educational session delivered by an infectious diseases physician reduced the use of inappropriate antibiotic therapy for inpatients with positive urine culture results. Further study is warranted to assess the long-term effect of this intervention.

[Assessment of antibiotic prescriptions in the emergency department of a general hospital. Prospective analysis of 211 prescriptions]. / Evaluation de la qualité des prescriptions antibiotiques dans le service d'accueil des urgences d'un centre hospitalier général. Analyse prospective de 211 prescriptions.

AIM: To study the appropriateness and conformity to antibiotic prescription guidelines in an emergency department and to assess the factors likely to influence them. METHODS: This prospective study included all adult patients visiting the emergency department over a period of 100 days and receiving antibiotic treatment. Two independent specialists in infectious disease assessed the appropriateness of the indications and the treatment's conformity with good practice guidelines. We also studied patient's status 7 days after initiation of antibiotic treatment, duration of hospitalization and any treatment changes. RESULTS: The study included 211 patients, 47% of them men. Prescriptions were appropriate in 53% of cases and in accordance with guidelines in 34%. Half of all prescriptions were related to urinary tract or pulmonary infections. Four antibiotic families accounted for 88% of prescriptions. Prescription errors were related to multidrug treatments, intravenous drugs, and inappropriate antibiotic families. More than half (56%) of the patients were admitted, and 70% of these remained in the hospital more than one week. Duration of treatment was inappropriate for 31% of the patients not admitted. In all, 44% of the antibiotic prescriptions ordered in the emergency department were later modified. CONCLUSION: Multidisciplinary work is essential in improving the quality of antibiotic prescriptions in an emergency department.