Infectious Disease

EDs, “easy targets” of emergency facilities for antibiotic management

January 05, 2021

2 min read

ADD SUBJECT TO EMAIL ALARMS

Receive an email when new articles are published

Please enter your email address to receive an email when new articles are published . “data-action =” subscribe “> subscribe

We could not process your request. Please try again later. If you continue to have this problem, please contact customerservice@slackinc.com.

Back to Healio

According to one study, more than 40% of antibiotics prescribed in EDs of the Veterans Health Administration and emergency centers for acute respiratory infections were prescribed with an inappropriate indication.

The researchers said the results show that there is great opportunity within the Veterans Health Administration (VHA) to improve the management of both viral and potentially bacterial acute respiratory infections (ARIs).

Daniel J. Livorsi

“I started this study because I wanted to understand other aspects of antibiotic prescribing in outpatient settings.” Daniel J. Livorsi, MD, MSc, Healio said, an assistant professor of medicine in the University of Iowa’s Carver College of Medicine and an infectious disease specialist in the Iowa City Veterans Affairs Health Care System. “Much emphasis has been placed on the unnecessary use of antibiotics for viral infections, but not so much on how well antibiotics are used when they are actually indicated.”

To evaluate the prescribing of antibiotics for viral and potentially bacterial acute ARIs in inpatients in EDs and Emergency Centers (UCCs), Livorsi and colleagues conducted a retrospective cohort study that included all ED and UCC visits from patients who were not in the hospital and were seen from 2016 to 2018 in the VHA. According to the study, there were 3,182,926 patient visits at 129 locations, 80.7% in EDs and 19.3% in UCCs.

The study found that 608,289 (19.1%) visits were prescribed antibiotics, including 42.7% with an “inappropriate indication”. According to the study, guideline-compliant management varied between clinicians for potentially bacterial ARIs (36.2%; interquartile range) [IQR] = 26-52.7) and digits (38.2%; IQR = 31.7-49.4). For viral ARIs, management varied according to guidelines between clinicians (46.2%; IQR = 24.1-68.6) and sites (40.0%; IQR = 30.4-59.3).

The researchers added that they found weak correlations between compliant management for viral and potentially bacterial ARIs in both clinicians and sites.

“The takeaway message is that there are some simple targets for antibiotic control in EDs and emergency clinics. In line with previous work, our study has shown that one of these goals is to stop the use of antibiotics in viral respiratory infections, ”said Livorsi.

“Our study also showed that additional targets use the shortest effective duration of therapy for suspected bacterial sinusitis and pneumonia,” he said. “In our study, these diseases were often treated with lengthy antibiotics. Finally, empirical antibiotic selection needs to be improved for common bacterial respiratory infections such as pneumonia. “

ADD SUBJECT TO EMAIL ALARMS

Receive an email when new articles are published

Please enter your email address to receive an email when new articles are published . “data-action =” subscribe “> subscribe

We could not process your request. Please try again later. If you continue to have this problem, please contact customerservice@slackinc.com.

Back to Healio

Related Articles