02:45am Wednesday 23 August 2017

Targeting Prescribers Can Reduce Excessive Use of Antibiotics in Hospitals

Some infections are no longer treatable due to bacterial resistance. Compared to infections caused by treatable bacteria, those caused by multidrug-resistant bacteria lead to more deaths, longer hospital stays and increased healthcare costs. Reducing inappropriate use of antibiotics should help to slow the spread of resistant bacteria. Achieving this is proving difficult as by most estimates, antibiotic use in hospitals is rising, with some evidence suggesting more than a third of prescriptions are inappropriate.

The review, published in The Cochrane Library, included 89 studies from 19 countries, with most studies aiming to decrease excessive antibiotic use. The researchers analysed data from two types of studies. In persuasive studies, doctors were given advice and feedback about prescribing antibiotics. In restrictive studies, restrictions were placed on prescribing, for example, doctors might be required to seek approval from a specialist. Overall, prescribing in hospitals improved and data from 21 studies showed that hospital infections decreased.

“Our review shows that a wide variety of different interventions have been successful in changing antibiotic prescription in hospitals,” said lead researcher Peter Davey, who is based at the Population Health Sciences Division at the University of Dundee in Dundee, UK. “However, we need more studies that explore how these changes benefit patients and how they impact on healthcare costs.”

Restrictive methods yielded greater improvements in prescription, although no studies undertook direct comparisons between restrictive and persuasive methods. “The fact that restrictive methods work well is important because it supports restriction of antibiotic use when the need is urgent, such as in an outbreak situation,” said Davey. “However, the evidence base would be enormously enhanced by direct comparisons with persuasive methods.”

Notes for editors

 

Full citation: Davey P, Brown E, Charani E, Fenelon L, Gould IM, Holmes A, Ramsay CR, Wiffen PJ, Wilcox M. Interventions to improve antibiotic prescribing practices for hospital inpatients. Cochrane Database of Systematic Reviews 2013, Issue 4. Art. No.: CD003543. DOI: 10.1002/14651858.CD003543.pub3.

 

URL upon publication: http://doi.wiley.com/10.1002/14651858.CD003543.pub3

 

Interviews: To arrange an interview with Professor Davey, please contact Roddy Isles, Head of Press at the University of Dundee on TEL: +44 (0) 1382 384910, MOBILE: +44 (0) 7800 581902, or E-MAIL: r.isles@dundee.ac.uk.

 

About The Cochrane Library
The Cochrane Library contains high quality health care information, including the Cochrane Database of Systematic Reviews, from the Cochrane Collaboration. Cochrane Systematic Reviews bring together research on the effects of health care and are considered the gold standard for determining the relative effectiveness of different interventions. The Cochrane Collaboration (www.cochrane.org) is a UK registered international charity and the world’s leading producer of systematic reviews. It has been demonstrated that Cochrane Systematic Reviews are of comparable or better quality and are updated more often than the reviews published in print journals (Wen J et al; The reporting quality of meta-analyses improves: a random sampling study. Journal of Clinical Epidemiology 2008; 61: 770-775).

 

In June 2012, the Cochrane Database of Systematic Reviews received an impact factor of 5.912, from Thomson ISI, placing it in the top ten general and internal medicine journals.

 

The Cochrane Library is published by Wiley on behalf of The Cochrane Collaboration.

 

The Cochrane Library Podcasts: a collection of podcasts on a selection of Cochrane Reviews by authors of reviews in this issue will be available from www.cochrane.org/podcasts.

 

Accessing The Cochrane Library
The Cochrane Library can be accessed at www.thecochranelibrary.com. Guest users may access abstracts and plain language summaries for all reviews in the database, and members of the media may request full access to the contents of the Library. For further information, see contact details below. A number of countries, including countries in the World Bank’s list of low- and low-middle income economies (countries with a gross national income (GNI) per capita of less than $4700), have national provisions by which some or all of their residents are able to access The Cochrane Library for free. To find out more, please visit www.thecochranelibrary.com/FreeAccess.

 

About Wiley
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Founded in 1807, John Wiley & Sons, Inc. (NYSE: JWa, JWb), has been a valued source of information and understanding for more than 200 years, helping people around the world meet their needs and fulfill their aspirations. Wiley and its acquired companies have published the works of more than 450 Nobel laureates in all categories: Literature, Economics, Physiology or Medicine, Physics, Chemistry, and Peace. Wiley’s global headquarters are located in Hoboken, New Jersey, with operations in the U.S., Europe, Asia, Canada, and Australia. The Company’s website can be accessed at www.wiley.com.

 

If you would like to see a full list of reviews published in the new issue of The Cochrane Library, or would like to request full access to the contents of The Cochrane Library, please email sciencenewsroom@wiley.com.

 

For media enquiries contact:
Roddy Isles
Head, Press Office
University of Dundee
Nethergate, Dundee, DD1 4HN
TEL: 01382 384910
E-MAIL: r.isles@dundee.ac.uk
MOBILE: 07800 581902


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