Antimicrobial prescribing at a university hospital: justified or 'just in case': testing a new scoring system as a key quality indicator

Pharmacoepidemiol Drug Saf. 2005 Aug;14(8):561-6. doi: 10.1002/pds.1097.

Abstract

Objective: To evaluate the quality of antimicrobial drug prescribing at a university hospital in the Department of Medicine, by using a new scoring system as a quality indicator.

Design: a prospective, longitudinal survey, during a 21-week period. The necessity of antimicrobial treatment of all in-patients at the Department of Medicine, to whom new antimicrobials were prescribed, was assessed by using a scoring system based on the presence of signs and symptoms of an infection. If the sum's total score was 3 or more, the antimicrobial treatment was deemed justifiable; if the score was less than 3, the antimicrobial treatment was regarded as questionable.

Setting: Department of Medicine (279 hospital-beds) at the University Hospital Center Rijeka, a 1200-patient-bed teaching hospital in Croatia.

Results: Antimicrobials were prescribed to 15% of the total patients. They were given as a treatment to 89% of the patients, and in 67% of the cases, this treatment was administered empirically. According to the scoring system, 29% of the patients did not have a justified indication for antimicrobial treatment.

Conclusion: The proposed quality indicator (scoring system) that we used is a simple method for the quality assessment of antimicrobial use. It has indicated areas that require in-depth analysis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Infective Agents / therapeutic use*
  • Bacterial Infections / drug therapy*
  • Bacterial Infections / epidemiology
  • Community-Acquired Infections / drug therapy
  • Community-Acquired Infections / microbiology
  • Croatia / epidemiology
  • Drug Prescriptions / standards*
  • Female
  • Hospital Departments / statistics & numerical data
  • Hospitals, University
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Odds Ratio
  • Prospective Studies
  • Quality Assurance, Health Care*

Substances

  • Anti-Infective Agents