Antibiotic Stewardship-Visiten: Zeitverschwendung oder Qualitätssteigerung?

Z Evid Fortbild Qual Gesundhwes. 2015;109(7):535-41. doi: 10.1016/j.zefq.2015.09.026. Epub 2015 Oct 30.
[Article in German]

Abstract

Introduction: One of the core strategies to optimize antiinfective therapy is to review antibiotic prescriptions. Therefore, Antibiotic Stewardship (ABS) team members either attend ward rounds or perform a chart review to provide feedback to and discuss with the attending physician. Acceptance and effectiveness of both options are discussed in this article.

Methods: Attending physicians were asked to complete a questionnaire evaluating ABS activities. The modality of the reviewing process and its effectiveness, as well as the feasibility of recommendations was assessed. As the degree of implementation of ABS recommendations decreased on a trauma ward, the reviewing process was changed from chart review to attending the daily ward rounds. In this setting, the duration of the reviewing process and the consumption of antiinfectives in recommended daily doses/100 patient days (RDD/100PT) were assessed, comparing the two intervention modalities.

Results: Attending physicians predominantly appreciated the modality and extent of ABS currently offered to them by the ABS team, rating it relevant and effective. Implementation of ABS recommendations was increased on the trauma ward by academic detailing during the daily ward round; the consumption of broad spectrum antibiotics was reduced.

Discussion: ABS team members with formal authority and dedicated time for antibiotic stewardship activities effectively optimize antiinfective therapies by reviewing antibiotic prescriptions. The interaction of ABS experts and attending physicians contributes fundamentally to the effectiveness and degree of implementation of ABS interventions.

Keywords: Antibiotic Stewardship; Evaluierung; Implementierung; evaluation; implementation.

MeSH terms

  • Anti-Bacterial Agents / therapeutic use*
  • Attitude of Health Personnel*
  • Cooperative Behavior
  • Cross Infection / drug therapy*
  • Drug Resistance, Microbial*
  • Drug Utilization / statistics & numerical data
  • Germany
  • Guideline Adherence / standards*
  • Humans
  • Infectious Disease Medicine / standards*
  • Interdisciplinary Communication
  • Medical Audit*
  • Quality Improvement / standards*
  • Referral and Consultation / standards
  • Surveys and Questionnaires
  • Teaching Rounds
  • Time and Motion Studies
  • Trauma Centers
  • Wounds and Injuries / surgery

Substances

  • Anti-Bacterial Agents