BARCELONA — A simple low-tech notation to stop prescribing antibiotics after a guideline set period dramatically reduced overuse of antibiotics — and adverse reactions to those treatments, researchers said here.
Compared to a period before the issuance of automatic stop dates for stopping antibiotic treatment, the duration of antibiotic use decreased 18.1% from 8.3 days to 6.8 days (P<0.001), said Matthew Lloyd, MD, a foundation doctor at Ninewells Hospital at the University of Dundee, Scotland.
During a press briefing at the annual meeting of the European Respiratory Society, Lloyd told MedPage Today that the adverse events associated with antibiotic use decreased by almost 40% from 31.3% to 19% (P<0.001).
In the year-long study, 281 patients were included in an observational period prior to the initiation of the automatic antibiotics stop orders. When compared with treatment of 221 post-intervention patients, Lloyd said there were reductions in antibiotic use days across all respiratory clinic patients:
- Pneumonia patients’ antibiotic use dropped from 9.3 days to 7.1 days (P<0.001)
- Chronic obstructive pulmonary disease (COPD) 7.7 days to 6.2 days (P<0.001)
- Asthma 6.3 days to 5.0 days (P<0.001)
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For other pulmonary diseases, patients’ antibiotic use dropped from 8.5 days to 6.6 days (P<0.001).
Also, there was a nonsignificant decrease in mortality from 8.9% to 8.1% (P=0.6).
The intervention is classically simple: Just a note on the hand-written prescription protocol forms in which the doctor places an “x” on the date when antibiotic use is to end, and then a line through the days for the remainder of the month to prevent the stop order from being overlooked.
The time limits on the use of antibiotics correlated with the severity of the infection, Lloyd said.
Date: Sep 12, 2013