Are local clinical guidelines useful in promoting rational use of antibiotic prophylaxis in Caesarean delivery?
Само за регистроване кориснике
2010
Чланак у часопису (Објављена верзија)
Метаподаци
Приказ свих података о документуАпстракт
Objectives To identify changes in prescribing patterns of antibiotic prophylaxis in Caesarean delivery after introduction of local clinical guidelines. To identify changes in outcomes of prescribing antibiotics following the implementation of local clinical guidelines on antibiotic prophylaxis. Setting University of Belgrade, Medical School, Clinic of Gynaecology and Obstetrics "Narodni front" Belgrade, Serbia. Method A quantitative retrospective analysis of antibiotic use before (January-June 2005), and following (January-June 2006) implementation of guidelines on antibiotic prophylaxis in two wards. Patients who underwent Caesarean section prior to (261) and following (281) introduction of local guidelines, participated in this study. Main outcome measures Drug utilization cost presented as the number of DDD/100 bed days/eur, the average duration of hospital stay, number of wound infections. Results There was a significant change in prescribing patterns of antibiotic prophylaxis in C...aesarean section following introduction of local guidelines. The use of ceftriaxone, amikacin and metronidazole decreased (57.47% vs. 11.74%; 9.19% vs. 4.27%; 61.69% vs. 46.26%, respectively). On the other hand, the use of "older" antibiotics such as gentamicin, cefuroxime, cefazolin and ampicillin increased (14.56% vs. 29.18%; 9.2% vs. 17.44%; 9.58% vs. 45.2% and 0% vs. 3.9%, respectively). DDD/100 bed days/eur analysis revealed a 47% decrease of total cost for prophylactic antibiotic treatment in Caesarean section following local guideline implementation. In contrast, rate of wound infections and duration of hospital stay were not significantly different in both groups. Conclusion In an attempt to ensure cost-effective prophylactic use of antibiotics in Caesarean delivery, local clinical guidelines were introduced. They resulted in changes in prescribing patterns of antibiotics. There was a significant decrease in use of 'third' generation of cephalosporin's whereas the use of "older" antibiotics with proven efficacy and safety increased. In contrast, there was no significant change in treatment outcomes such as wound infection and average hospital stay.
Кључне речи:
Antibiotic prophylaxis / Caesarean delivery / Formulary / Local clinical guidelines / SerbiaИзвор:
Pharmacy World & Science, 2010, 32, 2, 139-145Издавач:
- Springer, Dordrecht
Финансирање / пројекти:
DOI: 10.1007/s11096-009-9359-z
ISSN: 0928-1231
PubMed: 20039207
WoS: 000275799200008
Scopus: 2-s2.0-77953321526
Институција/група
PharmacyTY - JOUR AU - Ristić, Svetlana AU - Miljković, Branislava AU - Vezmar, Sandra AU - Stanojević, Dušan PY - 2010 UR - https://farfar.pharmacy.bg.ac.rs/handle/123456789/1379 AB - Objectives To identify changes in prescribing patterns of antibiotic prophylaxis in Caesarean delivery after introduction of local clinical guidelines. To identify changes in outcomes of prescribing antibiotics following the implementation of local clinical guidelines on antibiotic prophylaxis. Setting University of Belgrade, Medical School, Clinic of Gynaecology and Obstetrics "Narodni front" Belgrade, Serbia. Method A quantitative retrospective analysis of antibiotic use before (January-June 2005), and following (January-June 2006) implementation of guidelines on antibiotic prophylaxis in two wards. Patients who underwent Caesarean section prior to (261) and following (281) introduction of local guidelines, participated in this study. Main outcome measures Drug utilization cost presented as the number of DDD/100 bed days/eur, the average duration of hospital stay, number of wound infections. Results There was a significant change in prescribing patterns of antibiotic prophylaxis in Caesarean section following introduction of local guidelines. The use of ceftriaxone, amikacin and metronidazole decreased (57.47% vs. 11.74%; 9.19% vs. 4.27%; 61.69% vs. 46.26%, respectively). On the other hand, the use of "older" antibiotics such as gentamicin, cefuroxime, cefazolin and ampicillin increased (14.56% vs. 29.18%; 9.2% vs. 17.44%; 9.58% vs. 45.2% and 0% vs. 3.9%, respectively). DDD/100 bed days/eur analysis revealed a 47% decrease of total cost for prophylactic antibiotic treatment in Caesarean section following local guideline implementation. In contrast, rate of wound infections and duration of hospital stay were not significantly different in both groups. Conclusion In an attempt to ensure cost-effective prophylactic use of antibiotics in Caesarean delivery, local clinical guidelines were introduced. They resulted in changes in prescribing patterns of antibiotics. There was a significant decrease in use of 'third' generation of cephalosporin's whereas the use of "older" antibiotics with proven efficacy and safety increased. In contrast, there was no significant change in treatment outcomes such as wound infection and average hospital stay. PB - Springer, Dordrecht T2 - Pharmacy World & Science T1 - Are local clinical guidelines useful in promoting rational use of antibiotic prophylaxis in Caesarean delivery? VL - 32 IS - 2 SP - 139 EP - 145 DO - 10.1007/s11096-009-9359-z ER -
@article{ author = "Ristić, Svetlana and Miljković, Branislava and Vezmar, Sandra and Stanojević, Dušan", year = "2010", abstract = "Objectives To identify changes in prescribing patterns of antibiotic prophylaxis in Caesarean delivery after introduction of local clinical guidelines. To identify changes in outcomes of prescribing antibiotics following the implementation of local clinical guidelines on antibiotic prophylaxis. Setting University of Belgrade, Medical School, Clinic of Gynaecology and Obstetrics "Narodni front" Belgrade, Serbia. Method A quantitative retrospective analysis of antibiotic use before (January-June 2005), and following (January-June 2006) implementation of guidelines on antibiotic prophylaxis in two wards. Patients who underwent Caesarean section prior to (261) and following (281) introduction of local guidelines, participated in this study. Main outcome measures Drug utilization cost presented as the number of DDD/100 bed days/eur, the average duration of hospital stay, number of wound infections. Results There was a significant change in prescribing patterns of antibiotic prophylaxis in Caesarean section following introduction of local guidelines. The use of ceftriaxone, amikacin and metronidazole decreased (57.47% vs. 11.74%; 9.19% vs. 4.27%; 61.69% vs. 46.26%, respectively). On the other hand, the use of "older" antibiotics such as gentamicin, cefuroxime, cefazolin and ampicillin increased (14.56% vs. 29.18%; 9.2% vs. 17.44%; 9.58% vs. 45.2% and 0% vs. 3.9%, respectively). DDD/100 bed days/eur analysis revealed a 47% decrease of total cost for prophylactic antibiotic treatment in Caesarean section following local guideline implementation. In contrast, rate of wound infections and duration of hospital stay were not significantly different in both groups. Conclusion In an attempt to ensure cost-effective prophylactic use of antibiotics in Caesarean delivery, local clinical guidelines were introduced. They resulted in changes in prescribing patterns of antibiotics. There was a significant decrease in use of 'third' generation of cephalosporin's whereas the use of "older" antibiotics with proven efficacy and safety increased. In contrast, there was no significant change in treatment outcomes such as wound infection and average hospital stay.", publisher = "Springer, Dordrecht", journal = "Pharmacy World & Science", title = "Are local clinical guidelines useful in promoting rational use of antibiotic prophylaxis in Caesarean delivery?", volume = "32", number = "2", pages = "139-145", doi = "10.1007/s11096-009-9359-z" }
Ristić, S., Miljković, B., Vezmar, S.,& Stanojević, D.. (2010). Are local clinical guidelines useful in promoting rational use of antibiotic prophylaxis in Caesarean delivery?. in Pharmacy World & Science Springer, Dordrecht., 32(2), 139-145. https://doi.org/10.1007/s11096-009-9359-z
Ristić S, Miljković B, Vezmar S, Stanojević D. Are local clinical guidelines useful in promoting rational use of antibiotic prophylaxis in Caesarean delivery?. in Pharmacy World & Science. 2010;32(2):139-145. doi:10.1007/s11096-009-9359-z .
Ristić, Svetlana, Miljković, Branislava, Vezmar, Sandra, Stanojević, Dušan, "Are local clinical guidelines useful in promoting rational use of antibiotic prophylaxis in Caesarean delivery?" in Pharmacy World & Science, 32, no. 2 (2010):139-145, https://doi.org/10.1007/s11096-009-9359-z . .