Antibiotic optimization : An evaluation of patient safety and economic outcomes.
Although numerous reports have described interventions designed to influence antibiotic utilization, to our knowledge none have been evaluated in a randomized study.
Adult inpatients receiving 1 or more of 10 designated parenteral antibiotics for 3 or more days during a 3-month period were randomized to an intervention (n=141) and a control (n=111) group using an unblocked, computer-generated random number table.
Obstetric patients and those seen in infectious disease consultation were excluded.
The intervention group received antibiotic-related suggestions from a team consisting of an infectious disease fellow and a clinical pharmacist.
Both groups were evaluated for clinical and microbiological outcomes as well as antibiotic utilization via prospective chart reviews and analysis of the hospital's administrative database.
Sixty-two (49%) of the intervention group patients received a total of 74 suggestions.
Sixty-three (84%) of these suggestions were implemented ; the majority involved changes in antibiotic choice, dosing regimen, or route of administration.
Per patient antibiotic charges were nearly $400 less in the intervention group vs controls (P=05).
Almost all the savings were related to lower intravenous antibiotic charges.
Clinical and microbiological response, antibiotic-associated toxic effects, in-hospital mortality, and readmission rates were similar for both groups. (...)
Mots-clés Pascal : Antibiotique, Efficacité traitement, Randomisation, Coût, Evaluation, Symptomatologie, Voie administration, Facteur prédictif, Homme, Chimiothérapie, Economie santé
Mots-clés Pascal anglais : Antibiotic, Treatment efficiency, Randomization, Costs, Evaluation, Symptomatology, Route of administration, Predictive factor, Human, Chemotherapy, Health economy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0429064
Code Inist : 002B02S01. Création : 19/12/1997.