Evaluation of the appropriateness of prescribing of the intravenous combination amoxicillin/clavulanate in a teaching hospital
(2010)
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- [Background and objective:] Inappropriate use of antibiotics appears to be an increasing problem with important consequences on both antibiotic resistance and hospital costs. The purpose of this study was to evaluate the appropriateness of prescription of the intravenous combination amoxicillin/clavulanate (Augmentin). [Design:] Prospective, observational study. [Setting:] All the wards in a teaching hospital in Belgium were included, except paediatric and intensive care units. All patients receiving prophylactic or therapeutic intravenous Augmentin 1 g/100 mg or 2 g/200 mg between 23 March 2009 and 24 April 2009 were enrolled. Data were collected by a pharmacist and the appropriateness of antibiotic treatment was analysed in collaboration with an infectious diseases specialist according to local recommendations. [Main outcome measures:] Appropriateness of indication, dosage, iv-to-oral switch and duration of therapy. [Results:] One hundred and six patients were evaluated. The most common indications for amoxicillin/clavulanate prescribing were: respiratory tract infections (38%), surgical/interventional prophylaxis (28%) and intra-abdominal infections (11%). Overall, 43.4% of intravenous Augmentin prescriptions were fully appropriate and 56.6% of prescriptions had at least one inappropriate criterion. Indication for use was appropriate in 80.2% and dosage in 73.8% of cases. In contrast, the timing of iv-to-oral switch and duration of therapy were inappropriate in 64.4 and 52.9% of cases, respectively. [Conclusions:] This study identified two main areas for improving Augmentin prescribing: (1) the iv-to-oral switch, which is often too late or nonexistent and (2) the duration of therapy, which is too long particularly in respiratory tract infections. The results will be presented to clinicians to increase their awareness on this issue. The final aim is that the Pharmacy department implements specific interventions to optimize Augmentin prescribing.
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Artoisenet, C., Delaere, B., Ausselet, N., Hecq, J.-D., & Spinewine, A. (2010). Evaluation of the appropriateness of prescribing of the intravenous combination amoxicillin/clavulanate in a teaching hospital. Pharmacy World and Science : international journal of clinical pharmacy and pharmaceutical care, 32(2), 235. (Original work published 2010)