Where to start? The Irish Emergency Department Antimicrobial Discharge (EDAD) study: a multicentre, prospective cohort analysis.
JAC Antimicrob Resist
; 6(2): dlae038, 2024 Apr.
Article
en En
| MEDLINE
| ID: mdl-38476772
ABSTRACT
Objectives:
To determine the percentage of patients across Ireland who are discharged from the Emergency Department (ED) with an antimicrobial prescription, the indication, classification of infections, and guideline compliance. To identify potential areas for antimicrobial stewardship (AMS) interventions in the ED. Patients andmethods:
A multicentre, prospective cohort analysis study in EDs across eight hospitals in Ireland. At each site, patients aged 1â month and older who presented to the ED and were discharged directly from the ED were included. A random selection of records of patients discharged from the ED were reviewed until a minimum of 30 records with an infection diagnosis resulting in an antibiotic prescription were obtained per hospital. The number of patient discharges with no antibiotic prescriptions were included to calculate the denominator. The indication, infection classification and guideline compliance data were collected on the 30 prescriptions in the participating hospitals.Results:
A total of 2619 patient records were reviewed. Of these, 249 (9.5%) patients were discharged with antimicrobial prescriptions from the ED. Most (158; 63%) were classified as probable bacterial infection, 21 (8%) as probable viral, and 18 (7%) had no documented evidence of infection. Three indications accounted for 73% of antimicrobial prescriptions skin/soft tissue infection; ear, nose and throat infection; and urinary tract infection. Overall guideline compliance was 64%.Conclusions:
Several areas for AMS interventions to optimize antimicrobial prescribing in the ED were identified, including targeted local and national guideline reviews, delayed prescribing, improved point-of-care testing and prescriber and patient education.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Idioma:
En
Revista:
JAC Antimicrob Resist
Año:
2024
Tipo del documento:
Article
País de afiliación:
Irlanda
Pais de publicación:
Reino Unido