Impact of an empiric therapy guide on antibiotic prescribing in the emergency department

J Hosp Infect. 2020 Feb;104(2):188-192. doi: 10.1016/j.jhin.2019.09.017. Epub 2019 Sep 30.

Abstract

This quasi-experimental study compared the appropriate prescribing of antibiotics in the emergency department over a 3-month period before and after implementation of an empiric therapy guide (ETG). Overall appropriateness of antibiotic prescribing per Infectious Diseases Society of America (IDSA) guidelines increased significantly by 20.5% after implementation of the ETG (P<0.001). Prescribing for community-acquired pneumonia and cellulitis improved by 33.1% (P<0.001) and 35.5% (P=0.002), respectively. The rate of broad-spectrum antibiotic use decreased by 13.6% (P<0.001). Following the intervention, 90.5% of prescribers achieved at least 75% appropriate prescribing per IDSA guidelines (P<0.001). Appropriate antibiotic prescribing and rates of broad-spectrum antibiotic use were significantly improved following implementation of the ETG.

Keywords: Antimicrobial stewardship; Community-acquired pneumonia; Emergency department; Empiric therapy guide; Non-purulent cellulitis.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / therapeutic use*
  • Antimicrobial Stewardship / methods
  • Antimicrobial Stewardship / statistics & numerical data*
  • Community-Acquired Infections / drug therapy*
  • Emergency Service, Hospital
  • Female
  • Guideline Adherence / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • Practice Guidelines as Topic
  • Retrospective Studies

Substances

  • Anti-Bacterial Agents