New Strategy Aims to Reduce Inappropriate Use of Antibiotics
Blog Sep 17, 2013
A recent study by Researchers from the University of Dundee found that a new prescribing protocol could significantly reduce potential misuse of antibiotics. This finding may result in reduced patient harm and help to combat the rise in antibiotic resistance.
To understand more about the importance of this research I spoke with the study's lead author, Dr Matthew Lloyd.
AB: How big a concern is antibiotic resistance?
Matthew Lloyd (ML): Antibiotic resistance is a growing problem nationally in the UK and indeed globally across the world. Professor Dame Sally Davies, Chief Medical Officer for the UK government just this week was reinforcing this point and the implication that this may have for treating a variety of infections in the future.
AB: Your study details a new strategy to reduce misuse of antibiotics. What does protocols does it include and why are these important?
ML: The British Thoracic Society suggests that by using stop dates when prescribing antibiotics we may be able to prevent excessive antibiotic use in community acquired pneumonia. This, as far as we are aware, is not implemented on a trust level anywhere in the UK and was something we were interested in trialling. We ensured that every patient who was prescribed an antibiotic had a specific duration correlated to the severity of their infection. For a mild community acquired pneumonia patients received 5 days of antibiotics, 7 days for a moderate/severe infection and other durations depending on the type of infection. This ensured that the patient could not erroneously be exposed to inappropriately lengthy courses of antibiotics. This is important at a population level in promoting good antibiotic stewardship, reducing antibiotic resistance and trying to prevent healthcare acquired infections associated with antibiotic use including clostridium difficle infection. At an individual level would also expose the patient to adverse events experienced by the patient during that exposure i.e. side effects, intravenous access device infection etc
AB: What were the key findings from this study?
ML: The key findings were that by implementing the strategy we reduced antibiotic duration significantly, by 18%. This was associated with a 39% reduction in adverse events potentially attributable to antibiotic use. This was done with no statistically significant effect on inpatient mortality or length of stay.
AB: What impact do you see this study having?
ML: Locally we are continuing the intervention in our respiratory unit and there is interest from our acute medicine colleagues about introducing it in our acute medical admissions unit. We would hope as a study group that this simple and effective intervention could be implemented in any unit where antibiotics are prescribed for which there is clear evidence of specific course duration. This was discussed at the presentation I delivered at the European Respiratory Society's Annual Congress last week in Barcelona and received a warm welcome. The publicity the study has received in Scotland will hopefully reinforce this.