Improving appropriateness of antibiotic therapy: randomized trial of an intervention to foster reassessment of prescription after 3 days.

Full Abstract

OBJECTIVES: Reassessment of ongoing antibiotic therapy is an important step towards appropriate use of antibiotics. This study was conducted to evaluate the impact of a short questionnaire designed to encourage reassessment of intravenous antibiotic therapy after 3 days. PATIENTS AND METHODS: Patients hospitalized on the surgical and medical wards of a university hospital and treated with an intravenous antibiotic for 3-4 days were randomly allocated to either an intervention or control group. The intervention consisted of mailing to the physician in charge of the patient a three-item questionnaire referring to possible adaptation of the antibiotic therapy. The primary outcome was the time elapsed from randomization until a first modification of the initial intravenous antibiotic therapy. It was compared within both groups using Cox proportional-hazard modelling. RESULTS: One hundred and twenty-six eligible patients were randomized in the intervention group and 125 in the control group. Time to modification of intravenous antibiotic therapy was 14% shorter in the intervention group (adjusted hazard ratio for modification 1.28, 95% CI 0.99-1.67, P = 0.06). It was significantly shorter in the intervention group compared with a similar group of 151 patients observed during a 2 month period preceding the study (adjusted hazard ratio 1.17, 95% CI 1.03-1.32, P = 0.02). CONCLUSION: The results suggest that a short questionnaire, easily adaptable to automatization, has the potential to foster reassessment of antibiotic therapy.

Author information

Author/s: Senn, Laurence (L); Burnand, Bernard (B); Francioli, Patrick (P); Zanetti, Giorgio (G);

Affiliation: Division of Hospital Hygiene, University Hospital, Lausanne, Switzerland. Laurence.Senn(-atsign-)chuv.hospvd.ch

Journal and publication information

Publication Type: Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't

Journal: The Journal of antimicrobial chemotherapy (J Antimicrob Chemother), published in England. (Language: eng)

Reference: 2004-Jun; vol 53 (issue 6) : pp 1062-7

Dates: Created 2004/05/28; Completed 2004/08/20; Revised 2008/11/21;

PMID: 15128726, status: MEDLINE (last retrieval date: 2/18/2009, IMS Date: )

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