Antibiotic stewardship ward rounds and a dedicated prescription chart reduce antibiotic consumption and pharmacy costs without affecting inpatient mortality or re-admission rates

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dc.contributor.authorBoyles, Tom H.en_ZA
dc.contributor.authorWhitelaw, Andrewen_ZA
dc.contributor.authorBamford, Colleenen_ZA
dc.contributor.authorMoodley, Mischkaen_ZA
dc.contributor.authorBonorchis, Kimen_ZA
dc.contributor.authorMorris, Vidaen_ZA
dc.contributor.authorRawoot, Naazneenen_ZA
dc.contributor.authorNaicker, Vanishreeen_ZA
dc.contributor.authorLusakiewicz, Irenaen_ZA
dc.contributor.authorBlack, Johnen_ZA
dc.contributor.authorStead, Daviden_ZA
dc.contributor.authorLesosky, Maiaen_ZA
dc.contributor.authorRaubenheimer, Peteren_ZA
dc.contributor.authorDlamini, Siphoen_ZA
dc.contributor.authorMendelson, Marcen_ZA
dc.date.accessioned2014-07-07T12:26:19Z
dc.date.available2014-07-07T12:26:19Z
dc.date.issued2013-12-09
dc.descriptionCITATION: Boyles, T. H. et al. 2013. Antibiotic stewardship ward rounds and a dedicated prescription chart reduce antibiotic consumption and pharmacy costs without affecting inpatient mortality or re-admission rates. PLoS ONE, 8(12): e79747, doi:10.1371/journal.pone.0079747.
dc.descriptionThe original publication is available at http://journals.plos.org/plosone
dc.description.abstractBackground Antibiotic consumption is a major driver of bacterial resistance. To address the increasing burden of multi-drug resistant bacterial infections, antibiotic stewardship programmes are promoted worldwide to rationalize antibiotic prescribing and conserve remaining antibiotics. Few studies have been reported from developing countries and none from Africa that report on an intervention based approach with outcomes that include morbidity and mortality. Methods An antibiotic prescription chart and weekly antibiotic stewardship ward round was introduced into two medical wards of an academic teaching hospital in South Africa between January-December 2012. Electronic pharmacy records were used to collect the volume and cost of antibiotics used, the patient database was analysed to determine inpatient mortality and 30-day re-admission rates, and laboratory records to determine use of infection-related tests. Outcomes were compared to a control period, January-December 2011. Results During the intervention period, 475.8 defined daily doses were prescribed per 1000 inpatient days compared to 592.0 defined daily doses/1000 inpatient days during the control period. This represents a 19.6% decrease in volume with a cost reduction of 35% of the pharmacy’s antibiotic budget. There was a concomitant increase in laboratory tests driven by requests for procalcitonin. There was no difference in inpatient mortality or 30-day readmission rate during the control and intervention periods. Conclusions Introduction of antibiotic stewardship ward rounds and a dedicated prescription chart in a developing country setting can achieve reduction in antibiotic consumption without harm to patients. Increased laboratory costs should be anticipated when introducing an antibiotic stewardship program.
dc.description.urihttp://journals.plos.org/plosone/article?id=10.1371/journal.pone.0079747
dc.description.versionPublisher's version
dc.format.extent7 pages
dc.identifier.citationBoyles, T. H. et al. 2013. Antibiotic stewardship ward rounds and a dedicated prescription chart reduce antibiotic consumption and pharmacy costs without affecting inpatient mortality or re-admission rates. PLoS ONE, 8(12): e79747, doi:10.1371/journal.pone.0079747.
dc.identifier.issn1549-1676 (online)
dc.identifier.otherdoi:10.1371/journal.pone.0079747
dc.identifier.urihttp://hdl.handle.net/10019.1/93507
dc.language.isoen
dc.publisherPublic Library of Science
dc.rights.holderAuthors retain copyright
dc.subjectAntibioticsen_ZA
dc.subjectBacterial diseasesen_ZA
dc.subjectHospital pharmaciesen_ZA
dc.subjectHospitals -- South Africaen_ZA
dc.titleAntibiotic stewardship ward rounds and a dedicated prescription chart reduce antibiotic consumption and pharmacy costs without affecting inpatient mortality or re-admission ratesen_ZA
dc.typeArticle
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