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Critical steps in fluoroquinolones and carbapenems prescriptions: results from a prospective clinical audit.
Int J Clin Pract. 2007 Jan; 61(1):147-52.IJ

Abstract

Antibiotic misuse is associated with emergence of resistance and high expenditures. Fluoroquinolones (FQ) and carbapenems (CP) are drugs with considerable potential of resistance development and its disseminated use is a concern. We undertook a prospective clinical audit to evaluate prescriptions of FQ and CP in a multistep process. Each prescription was unfolded in the following steps: indication for antimicrobial therapy; adequacy of initial prescription, dosage and route; previous cultures; and parenteral-oral transition. There was no antibiotics indication in 8.9% of FQ and 1.5% of CP group (p = 0.07). In CP 25.8% of initial schemes were inappropriate (21% in FQ). Lack of switch to oral therapy comprised 25% of monthly costs of FQ. Inadequacy in initial choice accounted for 13.6% of CP expenses. We concluded that, in spite of infection control restrictive policies, inappropriateness of antibiotic usage is worrisome. Clinical audit in a multistep approach may identify possible flaws in this process.

Authors+Show Affiliations

Hospital Infection Control Committee, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil. seligman@via-rs.netNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

16889636

Citation

Seligman, B G S., et al. "Critical Steps in Fluoroquinolones and Carbapenems Prescriptions: Results From a Prospective Clinical Audit." International Journal of Clinical Practice, vol. 61, no. 1, 2007, pp. 147-52.
Seligman BG, Ribeiro RA, Kuchenbecker Rde S, et al. Critical steps in fluoroquinolones and carbapenems prescriptions: results from a prospective clinical audit. Int J Clin Pract. 2007;61(1):147-52.
Seligman, B. G., Ribeiro, R. A., Kuchenbecker, R. d. e. . S., Grings, A. O., Dos Santos, R. P., Machado, A. R., Casali, F. C., Guzatto, F., Morais, V. D., Schroeder, G., Küplich, N. M., Pires, M. R., Konkewicz, L. R., & Jacoby, T. (2007). Critical steps in fluoroquinolones and carbapenems prescriptions: results from a prospective clinical audit. International Journal of Clinical Practice, 61(1), 147-52.
Seligman BG, et al. Critical Steps in Fluoroquinolones and Carbapenems Prescriptions: Results From a Prospective Clinical Audit. Int J Clin Pract. 2007;61(1):147-52. PubMed PMID: 16889636.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Critical steps in fluoroquinolones and carbapenems prescriptions: results from a prospective clinical audit. AU - Seligman,B G S, AU - Ribeiro,R A, AU - Kuchenbecker,R de S, AU - Grings,A O, AU - Dos Santos,R P, AU - Machado,A R L, AU - Casali,F C, AU - Guzatto,F, AU - Morais,V D, AU - Schroeder,G, AU - Küplich,N M, AU - Pires,M R, AU - Konkewicz,L R, AU - Jacoby,T, Y1 - 2006/08/02/ PY - 2006/8/8/pubmed PY - 2007/4/11/medline PY - 2006/8/8/entrez SP - 147 EP - 52 JF - International journal of clinical practice JO - Int. J. Clin. Pract. VL - 61 IS - 1 N2 - Antibiotic misuse is associated with emergence of resistance and high expenditures. Fluoroquinolones (FQ) and carbapenems (CP) are drugs with considerable potential of resistance development and its disseminated use is a concern. We undertook a prospective clinical audit to evaluate prescriptions of FQ and CP in a multistep process. Each prescription was unfolded in the following steps: indication for antimicrobial therapy; adequacy of initial prescription, dosage and route; previous cultures; and parenteral-oral transition. There was no antibiotics indication in 8.9% of FQ and 1.5% of CP group (p = 0.07). In CP 25.8% of initial schemes were inappropriate (21% in FQ). Lack of switch to oral therapy comprised 25% of monthly costs of FQ. Inadequacy in initial choice accounted for 13.6% of CP expenses. We concluded that, in spite of infection control restrictive policies, inappropriateness of antibiotic usage is worrisome. Clinical audit in a multistep approach may identify possible flaws in this process. SN - 1368-5031 UR - https://www.unboundmedicine.com/medline/citation/16889636/Critical_steps_in_fluoroquinolones_and_carbapenems_prescriptions:_results_from_a_prospective_clinical_audit_ L2 - https://doi.org/10.1111/j.1742-1241.2006.00988.x DB - PRIME DP - Unbound Medicine ER -