Journal Article

Improving appropriateness of antibiotic therapy: randomized trial of an intervention to foster reassessment of prescription after 3 days

Laurence Senn, Bernard Burnand, Patrick Francioli and Giorgio Zanetti

in Journal of Antimicrobial Chemotherapy

Published on behalf of British Society for Antimicrobial Chemotherapy

Volume 53, issue 6, pages 1062-1067
Published in print June 2004 | ISSN: 0305-7453
Published online June 2004 | e-ISSN: 1460-2091 | DOI: http://dx.doi.org/10.1093/jac/dkh236
Improving appropriateness of antibiotic therapy: randomized trial of an intervention to foster reassessment of prescription after 3 days

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  • Medical Oncology
  • Critical Care

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Objectives: Reassessment of ongoing antibiotic therapy is an important step towards appropriate use of antibiotics. This study was conducted to evaluate the impact of a short questionnaire designed to encourage reassessment of intravenous antibiotic therapy after 3 days.

Patients and methods: Patients hospitalized on the surgical and medical wards of a university hospital and treated with an intravenous antibiotic for 3–4 days were randomly allocated to either an intervention or control group. The intervention consisted of mailing to the physician in charge of the patient a three-item questionnaire referring to possible adaptation of the antibiotic therapy. The primary outcome was the time elapsed from randomization until a first modification of the initial intravenous antibiotic therapy. It was compared within both groups using Cox proportional-hazard modelling.

Results: One hundred and twenty-six eligible patients were randomized in the intervention group and 125 in the control group. Time to modification of intravenous antibiotic therapy was 14% shorter in the intervention group (adjusted hazard ratio for modification 1.28, 95% CI 0.99–1.67, P = 0.06). It was significantly shorter in the intervention group compared with a similar group of 151 patients observed during a 2 month period preceding the study (adjusted hazard ratio 1.17, 95% CI 1.03–1.32, P = 0.02).

Conclusion: The results suggest that a short questionnaire, easily adaptable to automatization, has the potential to foster reassessment of antibiotic therapy.

Keywords: Keywords: anti-infective agents, decision support systems, quality of healthcare, comparative study

Journal Article.  3630 words.  Illustrated.

Subjects: Medical Oncology ; Critical Care

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