Literature DB >> 20039207

Are local clinical guidelines useful in promoting rational use of antibiotic prophylaxis in caesarean delivery?

Svetlana Ristić1, Branislava Miljković, Sandra Vezmar, Dusan Stanojević.   

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.

Entities:  

Mesh:

Year:  2009        PMID: 20039207     DOI: 10.1007/s11096-009-9359-z

Source DB:  PubMed          Journal:  Pharm World Sci        ISSN: 0928-1231


  33 in total

1.  Reducing infections among women undergoing cesarean section in Colombia by means of continuous quality improvement methods.

Authors:  M Weinberg; J M Fuentes; A I Ruiz; F W Lozano; E Angel; H Gaitan; B Goethe; S Parra; S Hellerstein; D Ross-Degnan; D A Goldmann; W C Huskins
Journal:  Arch Intern Med       Date:  2001-10-22

Review 2.  Changing clinical behaviour by making guidelines specific.

Authors:  Susan Michie; Marie Johnston
Journal:  BMJ       Date:  2004-02-07

Review 3.  Postpartum infection treatments: a review.

Authors:  Walter Chaim; Eliezer Burstein
Journal:  Expert Opin Pharmacother       Date:  2003-08       Impact factor: 3.889

4.  An audit of the implementation of guidelines to reduce wound infection following caesarean section.

Authors:  G M Taylor
Journal:  Health Bull (Edinb)       Date:  2000-01

Review 5.  A review of issues surrounding medically elective cesarean delivery.

Authors:  Susan R Miesnik; Barbara J Reale
Journal:  J Obstet Gynecol Neonatal Nurs       Date:  2007 Nov-Dec

6.  [Incidence of postpartum post-cesarean hysterectomy at the Institute of Gynecology and Obsterics, Clinical Center of Serbia, Belgrade].

Authors:  Radmila Sparić; Milan Dokić; Rajka Argirović; Sasa Kadija; Zorica Bogdanović; Vera Milenković
Journal:  Srp Arh Celok Lek       Date:  2007 Mar-Apr       Impact factor: 0.207

7.  Antibiotic use in five children's hospitals during 2002-2006: the impact of antibiotic guidelines issued by the Chinese Ministry of Health.

Authors:  Wenshuang Zhang; Xuzhuang Shen; Yi Wang; Yuan Chen; Min Huang; Qiyi Zeng; Jinghai Wei; Quan Lu; Gang Wang; Li Deng; Xiaohong Wang; Kaihu Yao; Sangjie Yu; Yonghong Yang
Journal:  Pharmacoepidemiol Drug Saf       Date:  2008-03       Impact factor: 2.890

Review 8.  Antibiotic prophylaxis regimens and drugs for cesarean section.

Authors:  L Hopkins; F Smaill
Journal:  Cochrane Database Syst Rev       Date:  2000

9.  Attributes of clinical guidelines that influence use of guidelines in general practice: observational study.

Authors:  R Grol; J Dalhuijsen; S Thomas; C Veld; G Rutten; H Mokkink
Journal:  BMJ       Date:  1998-09-26

Review 10.  Quantitative antibiotic use in hospitals: comparison of measurements, literature review, and recommendations for a standard of reporting.

Authors:  S P Kuster; C Ruef; B Ledergerber; A Hintermann; C Deplazes; L Neuber; R Weber
Journal:  Infection       Date:  2008-11-13       Impact factor: 3.553

View more
  4 in total

Review 1.  The Impact of Quality Improvement Interventions in Improving Surgical Infections and Mortality in Low and Middle-Income Countries: A Systematic Review and Meta-Analysis.

Authors:  James Jin; Salesi Akau Ola; Cheng-Har Yip; Peter Nthumba; Emmanuel A Ameh; Stijn de Jonge; Mira Mehes; Hon Iferemi Waiqanabete; Jaymie Henry; Andrew Hill
Journal:  World J Surg       Date:  2021-07-03       Impact factor: 3.352

2.  Economic burden of inappropriate antibiotic use for prophylactic purpose in shiraz, iran.

Authors:  N Hatam; M Askarian; A R Moravveji; O Assadian
Journal:  Iran Red Crescent Med J       Date:  2011-04-01       Impact factor: 0.611

Review 3.  Barriers and facilitators of implementing interventions to improve appropriate antibiotic use in low- and middle-income countries: a systematic review based on the Consolidated Framework for Implementation Research.

Authors:  Shishi Wu; Elias Tannous; Victoria Haldane; Moriah E Ellen; Xiaolin Wei
Journal:  Implement Sci       Date:  2022-05-12       Impact factor: 7.960

4.  Impact of collaborative physician-pharmacist stewardship strategies on prophylactic antibiotic practices: a quasi-experimental study.

Authors:  Antonelle Pardo; Vianney Ntabaza; Mathieu Rivolta; Aline Goulard; Serge Sténuit; Remy Demeester; Sandrine Milas; Pierre Duez; Stéphanie Patris; Marc Joris; Philippe Dony; Soraya Cherifi
Journal:  Antimicrob Resist Infect Control       Date:  2022-07-26       Impact factor: 6.454

  4 in total

北京卡尤迪生物科技股份有限公司 © 2022-2023.