| Title |
Assessments of Opportunities to Improve Antibiotic Prescribing in an Emergency Department: A Period Prevalence Survey
|
|---|---|
| Published in |
Infectious Diseases and Therapy, October 2017
|
| DOI | 10.1007/s40121-017-0175-9 |
| Pubmed ID | |
| Authors |
Tristan T. Timbrook, Aisling R. Caffrey, Anais Ovalle, Maya Beganovic, William Curioso, Melissa Gaitanis, Kerry L. LaPlante |
| Abstract |
Approximately 30% of all outpatient antimicrobials are inappropriately prescribed. Currently, antimicrobial prescribing patterns in emergency departments (ED) are not well described. Determining inappropriate antimicrobial prescribing patterns and opportunities for interventions by antimicrobial stewardship programs (ASP) are needed. A retrospective chart review was performed among a random sample of non-admitted, adult patients who received an antimicrobial prescription in the ED from January 1 to December 31, 2015. Appropriateness was measured using the Medication Appropriateness Index, and was based on provider adherence to local guidelines. Additional information collected included patient characteristics, initial diagnoses, and other chronic medication use. Of 1579 ED antibiotic prescriptions in 2015, we reviewed a total of 159 (10.1%) prescription records. The most frequently prescribed antimicrobial classes included penicillins (22.6%), macrolides (20.8%), cephalosporins (17.6%), and fluoroquinolones (17.0%). The most common indications for antibiotics were bronchitis or upper respiratory tract infection (URTI) (35.1%), followed by skin and soft tissue infection (SSTI) (25.0%), both of which were the most common reason for unnecessary prescribing (28.9% of bronchitis/URTIs, 25.6% of SSTIs). Of the antimicrobial prescriptions reviewed, 39% met criteria for inappropriateness. Among 78 prescriptions with a consensus on appropriate indications, 13.8% had inappropriate dosing, duration, or expense. Consistent with national outpatient prescribing, inappropriate antibiotic prescribing in the ED occurred in 39% of cases with the highest rates observed among patients with bronchitis, URTI, and SSTI. Antimicrobial stewardship programs may benefit by focusing on initiatives for these conditions among ED patients. Moreover, creation of local guideline pocketbooks for these and other conditions may serve to improve prescribing practices and meet the Core Elements of Outpatient Stewardship recommended by the Centers for Disease Control and Prevention. |
X Demographics
The data shown below were collected from the profiles of 9 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 3 | 33% |
| Spain | 1 | 11% |
| United Kingdom | 1 | 11% |
| Unknown | 4 | 44% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 6 | 67% |
| Scientists | 2 | 22% |
| Science communicators (journalists, bloggers, editors) | 1 | 11% |
Mendeley readers
The data shown below were compiled from readership statistics for 92 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 92 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Other | 12 | 13% |
| Student > Master | 10 | 11% |
| Researcher | 10 | 11% |
| Student > Bachelor | 6 | 7% |
| Student > Doctoral Student | 5 | 5% |
| Other | 16 | 17% |
| Unknown | 33 | 36% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 21 | 23% |
| Pharmacology, Toxicology and Pharmaceutical Science | 12 | 13% |
| Nursing and Health Professions | 4 | 4% |
| Agricultural and Biological Sciences | 4 | 4% |
| Biochemistry, Genetics and Molecular Biology | 3 | 3% |
| Other | 13 | 14% |
| Unknown | 35 | 38% |
Attention Score in Context
This research output has an Altmetric Attention Score of 5. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 25 October 2017.
All research outputs
#7,114,777
of 25,173,778 outputs
Outputs from Infectious Diseases and Therapy
#272
of 812 outputs
Outputs of similar age
#107,360
of 333,471 outputs
Outputs of similar age from Infectious Diseases and Therapy
#4
of 10 outputs
Altmetric has tracked 25,173,778 research outputs across all sources so far. This one has received more attention than most of these and is in the 71st percentile.
So far Altmetric has tracked 812 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 11.9. This one has gotten more attention than average, scoring higher than 66% of its peers.
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We're also able to compare this research output to 10 others from the same source and published within six weeks on either side of this one. This one has scored higher than 6 of them.