دورية أكاديمية

[Preventing prolonged antibiotic therapy by active implementation of switch guidelines].

التفاصيل البيبلوغرافية
العنوان: [Preventing prolonged antibiotic therapy by active implementation of switch guidelines].
عنوان ترانسليتريتد: Onnodig lange intraveneuze antibioticatherapie voorkomen door actieve implementatie van switchrichtlijnen.
المؤلفون: Handoko KB; Afd. Ziekenhuisapotheek, Medisch Centrum Haaglanden, Den Haag. k.handoko@zanob.nl, van Asselt GJ, Overdiek JW
المصدر: Nederlands tijdschrift voor geneeskunde [Ned Tijdschr Geneeskd] 2004 Jan 31; Vol. 148 (5), pp. 222-6.
نوع المنشور: Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't
اللغة: Dutch; Flemish
بيانات الدورية: Publisher: Vereniging NTvG Country of Publication: Netherlands NLM ID: 0400770 Publication Model: Print Cited Medium: Print ISSN: 0028-2162 (Print) Linking ISSN: 00282162 NLM ISO Abbreviation: Ned Tijdschr Geneeskd Subsets: MEDLINE
أسماء مطبوعة: Publication: 2017?-: Amsterdam : Vereniging NTvG
Original Publication: Houten : Bohn Stafleu van Loghum
مواضيع طبية MeSH: Anti-Bacterial Agents/*administration & dosage , Infections/*drug therapy, Administration, Oral ; Anti-Bacterial Agents/therapeutic use ; Costs and Cost Analysis ; General Surgery ; Hospitals/standards ; Humans ; Infusions, Intravenous ; Internal Medicine/methods ; Netherlands ; Orthopedics ; Practice Guidelines as Topic ; Prospective Studies ; Pulmonary Medicine ; Risk Factors ; Time Factors
مستخلص: Objective: To reduce the number of days of unnecessary intravenous antibiotic therapy via an early switch to oral antibiotic therapy.
Design: Prospective, open trial.
Methods: A guideline was drawn up for an early and yet safe switch from intravenous to oral antibiotic therapy. Patients on the wards of Internal Medicine, Pulmonology, Surgery and Orthopaedics of the Haaglanden Medical Centre in The Hague, the Netherlands, were followed for four months. A zero measurement at two months was followed by an intervention period of two months. The number of unnecessary days of intravenous antibiotic therapy was taken as the measure of effectiveness. A multidisciplinary team carried out the interventions, consisting of educational, supportive and guiding measures. Making progress measurable and giving feedback played an important role during the intervention.
Results: During the zero-measurement period on the Internal Medicine and Pulmonology wards, 26% (9/35) of patients were switched within the timeframe predefined by the guideline. The average number of unnecessary i.v. days was 2.4 (median: 2). During the intervention period, 84% (64/76) were switched within the predefined timeframe, with an average of 0.2 unnecessary i.v. days per patient (median: 0). There was thus a significantly lower number of unnecessary i.v. days after intervention (difference: 2.2; 95%-CI: 1.5-3.0). On the surgical and orthopaedic wards, 9% (2/22) of patients were switched within the predefined timeframe during the zero-measurement period, with an average of 7.3 unnecessary i.v. days (median: 5). During the intervention period, 52% of patients (17/33) were switched within the predefined timeframe, for an average of 1.1 unnecessary i.v. days (median: 0). The reduction in the number of unnecessary i.v. days was also significant here (difference: 6.2; 95%-CI: 2.9-9.5).
Conclusion: A significant reduction in the number of unnecessary days of intravenous antibiotic therapy was obtained via simple interventions carried out by a multidisciplinary team.
المشرفين على المادة: 0 (Anti-Bacterial Agents)
تواريخ الأحداث: Date Created: 20040227 Date Completed: 20040412 Latest Revision: 20191210
رمز التحديث: 20221213
PMID: 14983578
قاعدة البيانات: MEDLINE