The impact of microbiological cultures on antibiotic prescribing in general internal medicine wards: microbiological evaluation and antibiotic use

摘要: Antibiotics are frequently prescribed because of a clinical suspicion infection while results microbiological analysis still pending. Empirical therapy may be influenced by culture results, either discontinuation in the case negative cultures, or broadening narrowing (streamlining) spectrum antibiotics. Several strategies have been suggested to improve antibiotic prescribing, such as surveillance resistance, monitoring and auditing antibiotics use, use consensus guidelines computer decision support improving multidisciplinary co-operation [1–3]. Although appropriateness prescribing has investigated some [4–6], impact on not analysed [7,8]. In two longitudinal studies internal medicine wards, analyses were performed about 70% all episodes infection, relevant micro-organisms isolated 50% this resulted modification cases [7,9]. another study, Arbo et al. reported that cultures obtained within first 7 days after admission, isolation Staphylococcus aureus Gramnegative bacteria associated with [8]. We prospectively three general wards Dutch university hospital. Therapeutic (69 beds) at Maastricht University Hospital Netherlands was monitored over 12month period, between June 1996 1997. Patients HIV-infections kidney marrow transplantation excluded from study. Demographic characteristics, types, dose route administration daily for patients receiving The tests (growth susceptibility testing) its evaluated. following definitions employed. Infection episode episode: an defined documented suspected