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Inappropriateness of Intravenous Antibiotic Prescriptions at Hospital Discharge at a Tertiary Care hospital in Thailand

Authors Mahatumarat T, Pinmanee N, Injai W, Chaiwarith R

Received 3 July 2019

Accepted for publication 30 November 2019

Published 20 December 2019 Volume 2019:11 Pages 125—129

DOI https://doi.org/10.2147/DHPS.S221430

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Hemalkumar B Mehta


Tuanjai Mahatumarat,1 Napaporn Pinmanee,2 Wichchulada Injai,2 Romanee Chaiwarith1

1Division of Infectious Diseases, Department of Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; 2Division of Pharmacy, Maharaj Nakorn Chiang Mai Hospital, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand

Correspondence: Romanee Chaiwarith
Division of Infectious Diseases, Department of Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
Tel +66-5393-6457
Fax +66-5389-4231
Email rchaiwar@gmail.com

Background: Intravenous antibiotics, either as outpatient parenteral antimicrobial therapy (OPAT) or transition of care to community-based management, is a common practice in tertiary care hospitals to minimize hospital stays. However, infectious disease consultation was not mandated for those prescriptions. Therefore, we conducted this study to evaluate the appropriateness of intravenous antibiotic prescriptions at hospital discharge.
Methods: This retrospective cross-sectional study was conducted among patients receiving care at the internal medicine units of the Maharaj Nakorn Chiang Mai Hospital from November 1, 2015, to April 30, 2016. Intravenous antibiotics at hospital discharge were reviewed by an infectious diseases (ID) specialist.
Results: One hundred and twenty-nine prescriptions for 117 patients were reviewed. The most common diagnoses requiring intravenous antibiotics at hospital discharge were upper urinary tract infection (34.2%) and hepatobiliary tract infections (15.4%). The most common intravenous antibiotic was ceftriaxone (36.4%), followed by ertapenem (20.1%). Overall, the inappropriateness of prescriptions was 85.3%. The most common reason for inappropriateness was a failure to switch to oral antibiotics (52.7%), followed by incorrect duration (16.3%).
Conclusion: Antimicrobial stewardship should be considered for intravenous antibiotics at hospital discharge to reduce the inappropriateness of those prescriptions.

Keywords: parenteral antimicrobials, antimicrobial stewardship, outpatient parenteral antimicrobial therapy

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