Audit of antimicrobial prescriptions for community-acquired pneumonia: the experience of the group of primary healthcare facilities in Amadora
DOI:
https://doi.org/10.32385/rpmgf.v37i5.12985Keywords:
Clinical audit, Antimicrobial stewardship, Pneumonia, Quality of health careAbstract
Background: Non-judicious antimicrobial prescriptions are one of the main causes associated with the emergence of antimicrobial resistance. As such, clinical audits as tools for quality improvement within an institution are essential in local antimicrobial resistance prevention and control programs.
Methods: During the year 2019, in the group of primary healthcare facilities of Amadora we performed a clinical audit of antimicrobial prescriptions according to two guidelines by the General-Directorate of Health focusing on community-acquired pneumonia. All prescriptions done during 2018 that could be framed within the two previous guidelines were verified. The parameters audited were: the choice of antimicrobial, duration of therapy, and, in cases when the prescription did not follow the guidelines, whether that choice was justified in the electronic record of the patient.
Results: Overall, from 292 clinical records from 2018 which were audited, 42.0% were according to the guidelines. The percentage of antimicrobial prescriptions according to the guidelines varied in the different healthcare units from 0.0 to 63.4%.
Conclusion: This audit using historical clinical records, allowed us to create a methodology for future internal audits within our institution. It also allowed us to readjust the training strategy within our group of primary healthcare facilities. There has not been an evaluation of the effectiveness of this audit.
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References
Rodrigues AT, Roque F, Falcão A, Figueiras A, Herdeiro MT. Understanding physician antibiotic prescribing behaviour: a systematic review of qualitative studies. Int J Antimicrob Agents. 2013;41(3):203-12.
European Commission. EU guidelines for the prudent use of antimicrobials in human health: Commission notice. Off J Eur Union. 2017;C(212):1-12.
Direção-Geral da Saúde. Programa de prevenção e controlo de infeções e de resistência aos antimicrobianos [homepage[. Lisboa: DGS; 2013. Available from: https://www.dgs.pt/programa-de-prevencao-e-controlo-de-infecoes-e-de-resistencia-aos-antimicrobianos/apresentacao.aspx
Doron S, Davidson LE. Antimicrobial stewardship. Mayo Clin Proc. 2011;86(11):1113-23.
Esposito P, Dal Canton A. Clinical audit, a valuable tool to improve quality of care: general methodology and applications in nephrology. World J Nephrol. 2014;3(4):249-55.
Direção-Geral da Saúde. Estratégia nacional para a qualidade na saúde [homepage]. Lisboa: DGS; 2015. Available from: https://www.dgs.pt/qualidade-e-seguranca/estrategia-nacional-para-a-qualidade-na-saude.aspx
National Institute for Health and Care Excellence. Antimicrobial stewardship: systems and processes for effective antimicrobial medicine use [homepage]. NICE; 2015. Available from: https://www.nice.org.uk/guidance/ng15
Direção-Geral da Saúde. Diagnóstico e tratamento da pneumonia adquirida na comunidade em idade pediátrica: norma nº 019/2012, de 26/12/2012. Lisboa: DGS; 2012.
Direção-Geral da Saúde. Antibioterapia na pneumonia adquirida na comunidade em adultos imunocompetentes: norma nº 045/2011, de 26/12/2011. Lisboa: DGS; 2011.
Administração Central do Sistema de Saúde. Classificação internacional de cuidados de saúde primários (segunda edição): ICPC-2E V4.4 PT [Internet]. Lisboa: ACSS; 2016. Available from: http://www.acss.min-saude.pt/wp-content/uploads/2016/07/1_ICPC_2_4_4_VF.pdf
Foy R, Eccles MP, Jamtvedt G, Young J, Grimshaw JM, Baker R. What do we know about how to do audit and feedback? Pitfalls in applying evidence from a systematic review. BMC Health Serv Res. 2005;5:50.
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