Effectiviteit en efficiëntie van antibioticaswitch in de ziekenhuisapotheek.

OBJECTIVE An earlier switch to oral antibiotics (AB po) can reduce inappropriate use of intravenous antibiotics (AB iv) and comes with certain benefits: decreased workload, reduced risk of complications, and decreased patient discomfort. Therefore, we examined how an earlier switch from AB iv to AB po can be executed optimally in a hospital setting. DESIGN Prospective, explorative intervention study. METHODS Besides the self ­ developed decision support system to detect AB iv, three intervention phases have been set up. Phase 1: pharmacist reports to the microbiologist in the Antimicrobial stewardship team (A ­ Team). Afterwards, the microbiologist discusses the option of switching to AB po with the treating physician. Phase 2: the pharmacist dis ­ cusses the option of switching to AB po with the treating physician. Phase 3: the pharmacist only checks required data for earlier switch to AB po. RESULTS 713 AB iv have been prescribed for 555 patients during the three phases and follow ­ up. For phase 1, 2 and 3 effective-ness was 39%, 48% and 50%, respectively, and pharmacist spent 3.2, 1.4 and 1.0 hours per day, respectively, on AB Switch. Phase 3 has been performed during follow ­ up thus achieving better effectiveness (67%) and better efficiency (0.9 hours per day). CONCLUSION These improvements are due to trainings provided by the A ­ Team, improved documentation of physicians (including indication and antibiotics policy), and increased awareness to switch earlier to AB po. [ABSTRACT FROM AUTHOR]