Earlier switching from intravenous to oral antibiotics owing to electronic reminders.
- Beeler PE Research Center for Medical Informatics, University Hospital Zurich and University of Zurich, Zurich, Switzerland.
- Kuster SP Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich and University of Zurich, Zurich, Switzerland.
- Eschmann E Research Center for Medical Informatics, University Hospital Zurich and University of Zurich, Zurich, Switzerland.
- Weber R Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich and University of Zurich, Zurich, Switzerland.
- Blaser J Research Center for Medical Informatics, University Hospital Zurich and University of Zurich, Zurich, Switzerland. Electronic address: juerg.blaser@usz.ch.
- 2015-08-22
Published in:
- International journal of antimicrobial agents. - 2015
Anti-infective agents/administration & dosage
Antibacterial agents
Decision support systems, clinical
Medical informatics, reminder systems
Administration, Intravenous
Administration, Oral
Adult
Aged
Aged, 80 and over
Anti-Bacterial Agents
Bacterial Infections
Catheter-Related Infections
Controlled Before-After Studies
Female
Humans
Male
Middle Aged
Prospective Studies
Reminder Systems
Young Adult
English
UNLABELLED
Paper-based interventions have been shown to stimulate switching from intravenous (i.v.) to oral (p.o.) antibiotic therapies. Shorter i.v. durations are associated with a lower risk of iatrogenic infections as well as reduced workload and costs. The purpose of this study was to determine whether automated electronic reminders are able to promote earlier switching. In this controlled before-and-after study, an algorithm identified patients who were eligible for i.v.-to-p.o. switch 60 h after starting i.v. antimicrobials. Reminders offering guidance on the re-assessment of initial i.v. therapy were displayed within the electronic health records in 12 units during the intervention period (year 2012). In contrast, no reminders were visible during the baseline period (2011) and in the control group (17 units). A total of 22863 i.v. antibiotic therapies were analysed; 6082 (26.6%) were switched to p.o.
THERAPY
In the intervention group, 757 courses of i.v. antibiotics were administered for a mean ± standard deviation duration of 5.4 ± 8.1 days before switching to p.o. antibiotics in the baseline period, and 794 courses for 4.5 ± 5.5 days in the intervention period (P = 0.004), corresponding to a 17.5% reduction of i.v. administration time. In contrast, in the control group the duration increased; 2240 i.v. antibiotics were administered for a mean duration of 4.0 ± 5.9 days in the baseline period, and 2291 for 4.3 ± 5.8 days in the intervention period (P = 0.03). Electronic reminders fostered earlier i.v.-to-p.o. switches, thereby reducing the duration of initial i.v. therapies by nearly a day.
Paper-based interventions have been shown to stimulate switching from intravenous (i.v.) to oral (p.o.) antibiotic therapies. Shorter i.v. durations are associated with a lower risk of iatrogenic infections as well as reduced workload and costs. The purpose of this study was to determine whether automated electronic reminders are able to promote earlier switching. In this controlled before-and-after study, an algorithm identified patients who were eligible for i.v.-to-p.o. switch 60 h after starting i.v. antimicrobials. Reminders offering guidance on the re-assessment of initial i.v. therapy were displayed within the electronic health records in 12 units during the intervention period (year 2012). In contrast, no reminders were visible during the baseline period (2011) and in the control group (17 units). A total of 22863 i.v. antibiotic therapies were analysed; 6082 (26.6%) were switched to p.o.
THERAPY
In the intervention group, 757 courses of i.v. antibiotics were administered for a mean ± standard deviation duration of 5.4 ± 8.1 days before switching to p.o. antibiotics in the baseline period, and 794 courses for 4.5 ± 5.5 days in the intervention period (P = 0.004), corresponding to a 17.5% reduction of i.v. administration time. In contrast, in the control group the duration increased; 2240 i.v. antibiotics were administered for a mean duration of 4.0 ± 5.9 days in the baseline period, and 2291 for 4.3 ± 5.8 days in the intervention period (P = 0.03). Electronic reminders fostered earlier i.v.-to-p.o. switches, thereby reducing the duration of initial i.v. therapies by nearly a day.
- Language
-
- English
- Open access status
- green
- Identifiers
-
- DOI 10.1016/j.ijantimicag.2015.06.013
- PMID 26293470
- Persistent URL
- https://sonar.ch/global/documents/298556
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