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Effect of a Comprehensive, Multidisciplinary, Educational Program on the Use of Antibiotics in a Geriatric University Hospital
Author(s) -
Lutters Monika,
Harbarth Stephan,
Janssens JeanPaul,
Freudiger Hans,
Herrmann François,
Michel JeanPierre,
Vogt Nicole
Publication year - 2004
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2004.52019.x
Subject(s) - medicine , multidisciplinary approach , geriatrics , antibiotics , family medicine , gerontology , intensive care medicine , psychiatry , microbiology and biotechnology , biology , social science , sociology
Objectives: To assess the effect of a comprehensive, educational antibiotic management program designed to improve antibiotic use and reduce treatment costs in elderly patients with suspected urinary or respiratory tract infection. Design: Interventional cohort study with 12 cross‐sectional drug utilization reviews of antibiotic use before, during, and after the multifaceted intervention. Setting: A 304‐bed university hospital for geriatric patients. Participants: A total of 3,383 elderly patients. Interventions: An educational program including distribution of guidelines on the diagnosis and treatment of urinary and respiratory tract infections; lectures on geriatric infectious diseases; weekly ward rounds for patients with suspected infection; and targeted, individual counseling on diagnosis and antibiotic treatment of infections. Measurements: Antibiotic utilization data were collected from the patients' records. Antimicrobial costs were calculated using 1998 hospital wholesale prices. Results: Of 3,383 screened patients, 680 (20%) received at least one antibiotic. During the study period, the mean number of prescribed drugs per patient increased from 5.9 to 7.6 (29%; P <.001). In contrast, a reduction of 15% was observed in the proportion of patients exposed to antibiotic agents ( P =.08) and a drop of 26% in the number of antibiotics administered ( P <.001). This resulted in a 54% decrease in cumulative daily antibiotic costs. In 83 (75%) of 110 surveyed patients, the guidelines were correctly implemented. The intervention had no measurable negative clinical effect. Conclusion: A comprehensive, multifaceted educational program for treating urinary and respiratory tract infections in the elderly was a safe and practical method to change physicians' antibiotic prescribing practice and significantly reduce the consumption and costs of antibiotics in a geriatric hospital.