Professional practice evaluation of emergency department prescriptions for community-acquired infections in Lebanon

Background: Selecting the appropriate antibiotic regimen is extremely important in improving patient outcomes, minimizing antimicrobial resistance, and reducing costs. This study was conducted to evaluate current prescribing practices for empiric antibiotics at the time of admission to the emergency department (ED) and to assess their appropriateness in Lebanon.

Methods: A retrospective observational study was conducted at three different Lebanese hospitals between June and December 2016. Adult patients who received antibiotics in the ED during the study period were included. The assessment of antibiotic therapy based on adherence to international guidelines, including the choice of antibiotic, dosing, or both, was considered for analysis.

Results: A total of 258 patients who had a single diagnosis of an infectious disease were included. Adherence to international guidelines was noted in only 32.6% of cases; the frequency was highest for skin and soft tissue infections (50.0%), followed by urinary tract infections (40%). Among the different antibiotic classes, the highest percentage of drug incompatibility was for β-lactam prescriptions (70.8%). The percentage of incompatibility with guidelines for administered regimens on the basis of drug selection, dosing, or both was 53.4%, 10.3%, and 36.2%, respectively.

Conclusions: Inappropriate antibiotic use in the ED is prevalent, and physician adherence to international guidelines for empiric antibiotic prescriptions in the ED remains low. This emphasizes the importance of monitoring the use of antibiotics in the ED, as there is growing concern for antibiotic resistance and healthcare safety.