Antibiotics (Jul 2020)

Day 10 Post-Prescription Audit Optimizes Antibiotic Therapy in Patients with Bloodstream Infections

  • Rita Murri,
  • Claudia Palazzolo,
  • Francesca Giovannenze,
  • Francesco Taccari,
  • Marta Camici,
  • Teresa Spanu,
  • Brunella Posteraro,
  • Maurizio Sanguinetti,
  • Roberto Cauda,
  • Massimo Fantoni

DOI
https://doi.org/10.3390/antibiotics9080437
Journal volume & issue
Vol. 9, no. 8
p. 437

Abstract

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This study aimed to investigate the clinical and organizational impact of an active re-evaluation (on day 10) of patients on antibiotic treatment diagnosed with bloodstream infections (BSIs). A prospective, single center, pre-post quasi-experimental study was performed. Patients were enrolled at the time of microbial BSI confirmation. In the pre-intervention phase (August 2014–August 2015), clinical status and antibiotic regimen were re-evaluated at day 3. In the intervention phase (January 2016–January 2017), clinical status and antibiotic regimen were re-evaluated at day 3 and day 10. Primary outcomes were rate of optimal therapy, duration of antibiotic therapy, length of hospitalization, and 30-day mortality. A total of 632 patients were enrolled (pre-intervention period, n = 303; intervention period, n = 329). Average duration of therapy reduced from 18.1 days (standard deviation (SD), 11.4) in the pre-intervention period to 16.8 days (SD, 12.7) in the intervention period (p p = 0.001). No inter-group difference was found for the rate of 30-day mortality. In patients with BSI, re-evaluation of clinical status and antibiotic regimen at day 3 and 10 after microbiological diagnosis was correlated with a reduction in the duration of antibiotic therapy and hospital stay. The intervention is simple and has a low impact on overall costs.

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