Wednesday, January 14, 2015

Antibiotics Therapy Optimization- Room for Improvement

It is a common opinion that antibiotics are misused in US hospitals. The fears of evolving antibiotic resistance continue to grow.

When empiric antibiotics are prescribed on hospitalized patients, how appropriately are they prescribed and how quickly are they streamlined or discontinued? Here is an article published in Lancet Infectious Diseases which raises concerns in my opinion.

Across 6 US hospitals ( 2 university hospitals, a public community hospital and 3 private community hospitals) over a course of one year, of the 1200 selected patients on antibiotics, 30% had no fever and normal WBC counts, appropriate cultures were obtained on 59% of patients and, after 5 days of therapy, 66 % of patients had no change in their antibiotic therapy. 

Antibiotics are overused, particularly ones with a broad therapeutic spectrum, frequently on patients with no clinical signs of infection or fever. Concerning.

We only have ourselves to blame for the ongoing rise in drug resistance and C.difficile infections.

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