Cochrane Press Release: Interventions to improve antibiotic prescribing practices for hospital inpatients

The BSAC welcomes the publication of the Cochrane Review: Interventions to improve antibiotic prescribing practices for hospital inpatients from the Cochrane Effective Practice and Organisation of Care Group.

Key messages:

  • The updated Cochrane Review published today has identified effective and safe ways to reduce unnecessary use of antibiotics in hospitals.
  • Guidelines and policies that promote better targeting of antibiotics in patients who need them have the greatest impact when they are supported by the most effective ways to change doctors’ behaviour.

Context:

  • Antibiotic resistance has become a major public health problem with some infections no longer treatable using currently available drugs.
  • Inappropriate use of antibiotics is associated with the increase of resistance, and studies have shown that about half of the time physicians in hospital are not prescribing antibiotics appropriately.

What Does the Review Say?:

  • The researchers found 221 studies from the US, Europe, Asia, South America, and Australia.
  • The interventions broadly fell into two categories. ‘Restrictive’ techniques applied rules to make physicians prescribe properly, whilst ‘enabling’ techniques provide advice or feedback to help physicians make more informed prescribing decisions.
  • The researchers found high-quality evidence from 29 randomized studies in 23,394 inpatients that following either type of intervention 58% of hospital in-patients received treatment in line with prescribing guidelines, compared with 43% of the patients in the standard practice groups.
  • The interventions shorten the duration of antibiotic use from 11 days to 9 per patient, and probably reduce hospital stay from an average of 13 days to 12 per patient.
  • Data from 28 randomized studies of 15,827 patients showed that the risk of death was 11% in both treatment groups, suggesting that reducing antibiotic use did not lead to an increase in harm.
  • Cochrane lead author Peter Davey, from the Population Health Sciences Division at the University of Dundee in Dundee, UK said, “This Cochrane Review shows that a wide variety of different interventions have been successful in safely reducing unnecessary antibiotic use in hospitals.”
  • This research was supported by grants from the Chief Scientist Office, Scottish Government and the British Society for Antimicrobial Chemotherapy.

To view the Press Release, please click here

For the podcast for the Interventions to improve antibiotic prescribing practices for hospital inpatients review click here

To view the Review in the Cochrane Library please click here

View the Cochrane Editorial approved by PHE and ECDC and written by Diamantis Plachouras from the European Centre for Disease Prevention and Control, Stockholm, Sweden, and Susan Hopkins from Public Health England, London, UK.

Lead Author and Media Spokesperson: 
Peter Davey, Lead Clinician for Clinical Quality Improvement
Population Health Sciences University of Dundee
Mackenzie Building
Kirsty Semple Way
Dundee
Scotland, DD2 4BF
UK.
p.g.davey@dundee.ac.uk

For all media enquiries, please contact: Jo Anthony: M +44(0) 7582 726 634 E janthony@cochrane.org or pressoffice@cochrane.org

 

 

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