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dc.contributor.authorDenny, Kerina J
dc.contributor.authorGartside, Jessica G
dc.contributor.authorAlcorn, Kylie
dc.contributor.authorCross, Jack W
dc.contributor.authorMaloney, Samuel
dc.contributor.authorKeijzers, Gerben
dc.date.accessioned2019-05-29T12:45:12Z
dc.date.available2019-05-29T12:45:12Z
dc.date.issued2019
dc.identifier.issn0305-7453
dc.identifier.doi10.1093/jac/dky447
dc.identifier.urihttp://hdl.handle.net/10072/384313
dc.description.abstractBackground Antibiotics are some of the most commonly prescribed drugs in the Emergency Department (ED) and yet data describing the overall appropriateness of antibiotic prescribing in the ED is scarce. Objectives To describe the appropriateness of antibiotic prescribing in the ED. Methods A retrospective, observational study of current practice. All patients who presented to the ED during the study period and were prescribed at least one antibiotic were included. Specialists from Infectious Disease, Microbiology and Emergency Medicine and a Senior Pharmacist assessed antibiotic appropriateness against evidence-based guidelines. Results A total of 1019 (13.6%) of patient presentations involved the prescription of at least one antibiotic. Of these, 640 (62.8%) antibiotic prescriptions were assessed as appropriate, 333 (32.7%) were assessed as inappropriate and 46 (4.5%) were deemed to be not assessable. Adults were more likely to receive an inappropriate antibiotic prescription than children (36.9% versus 22.9%; difference 14.1%, 95% CI 7.2%–21.0%). Patients who met quick Sepsis-related Organ Failure Assessment (qSOFA) criteria were more likely to be prescribed inappropriate antibiotics (56.7% versus 36.1%; difference 20.5%, 95% CI, 2.4%–38.7%). There was no difference in the incidence of appropriate antibiotic prescribing based on patient gender, disposition (admitted/discharged), reason for antibiotic administration (treatment/prophylaxis) or time of shift (day/night). Conclusions Inappropriate administration of antibiotics can lead to unnecessary adverse events, treatment failure and antimicrobial resistance. With over one in three antibiotic prescriptions in the ED being assessed as inappropriate, there is a pressing need to develop initiatives to improve antibiotic prescribing to prevent antibiotic-associated patient and community harms.
dc.description.peerreviewedYes
dc.languageEnglish
dc.publisherOXFORD UNIV PRESS
dc.relation.ispartofpagefrom515
dc.relation.ispartofpageto520
dc.relation.ispartofissue2
dc.relation.ispartofjournalJOURNAL OF ANTIMICROBIAL CHEMOTHERAPY
dc.relation.ispartofvolume74
dc.subject.fieldofresearchMedical Microbiology
dc.subject.fieldofresearchMicrobiology
dc.subject.fieldofresearchPharmacology and Pharmaceutical Sciences
dc.subject.fieldofresearchcode1108
dc.subject.fieldofresearchcode0605
dc.subject.fieldofresearchcode1115
dc.titleAppropriateness of antibiotic prescribing in the Emergency Department
dc.typeJournal article
dc.type.descriptionC1 - Articles
dc.type.codeC - Journal Articles
gro.hasfulltextNo Full Text
gro.griffith.authorKeijzers, Gerben
gro.griffith.authorGartside, Jessica G.


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