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 Hen_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.date.accessioned2016-01-11T06:53:26Z
dc.date.available2016-01-11T06:53:26Z
dc.date.issued2013en_ZA
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.en_ZA
dc.identifier.apacitationBoyles, T. H., Whitelaw, A., Bamford, C., Moodley, M., Bonorchis, K., Morris, V., ... Black, J. (2013). Antibiotic stewardship ward rounds and a dedicated prescription chart reduce antibiotic consumption and pharmacy costs without affecting inpatient mortality or re-admission rates. <i>PLoS One</i>, http://hdl.handle.net/11427/16276en_ZA
dc.identifier.chicagocitationBoyles, Tom H, Andrew Whitelaw, Colleen Bamford, Mischka Moodley, Kim Bonorchis, Vida Morris, Naazneen Rawoot, Vanishree Naicker, Irena Lusakiewicz, and John Black "Antibiotic stewardship ward rounds and a dedicated prescription chart reduce antibiotic consumption and pharmacy costs without affecting inpatient mortality or re-admission rates." <i>PLoS One</i> (2013) http://hdl.handle.net/11427/16276en_ZA
dc.identifier.citationBoyles, T. H., Whitelaw, A., Bamford, C., Moodley, M., Bonorchis, K., Morris, V., ... & Stead, D. (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.0079747en_ZA
dc.identifier.ris TY - Journal Article AU - Boyles, Tom H AU - Whitelaw, Andrew AU - Bamford, Colleen AU - Moodley, Mischka AU - Bonorchis, Kim AU - Morris, Vida AU - Rawoot, Naazneen AU - Naicker, Vanishree AU - Lusakiewicz, Irena AU - Black, John AB - BACKGROUND: 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. DA - 2013 DB - OpenUCT DO - 10.1371/journal.pone.0079747 DP - University of Cape Town J1 - PLoS One LK - https://open.uct.ac.za PB - University of Cape Town PY - 2013 T1 - Antibiotic stewardship ward rounds and a dedicated prescription chart reduce antibiotic consumption and pharmacy costs without affecting inpatient mortality or re-admission rates TI - Antibiotic stewardship ward rounds and a dedicated prescription chart reduce antibiotic consumption and pharmacy costs without affecting inpatient mortality or re-admission rates UR - http://hdl.handle.net/11427/16276 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/16276
dc.identifier.urihttp://dx.doi.org/10.1371/journal.pone.0079747
dc.identifier.vancouvercitationBoyles TH, Whitelaw A, Bamford C, Moodley M, Bonorchis K, Morris V, et al. 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. 2013; http://hdl.handle.net/11427/16276.en_ZA
dc.language.isoengen_ZA
dc.publisherPublic Library of Scienceen_ZA
dc.publisher.departmentInstitute of Infectious Disease and Molecular Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.en_ZA
dc.rights.holder© 2013 Boyles et alen_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/4.0en_ZA
dc.sourcePLoS Oneen_ZA
dc.source.urihttp://journals.plos.org/plosoneen_ZA
dc.subject.otherAntibioticsen_ZA
dc.subject.otherAntibiotic resistanceen_ZA
dc.subject.otherChartsen_ZA
dc.subject.otherInpatientsen_ZA
dc.subject.otherDeath ratesen_ZA
dc.subject.otherNosocomial infectionsen_ZA
dc.subject.otherLaboratory testsen_ZA
dc.subject.otherHospitalsen_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.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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