UZH-Logo

Maintenance Infos

Earlier switching from intravenous to oral antibiotics owing to electronic reminders - Zurich Open Repository and Archive


Beeler, Patrick E; Kuster, Stefan P; Eschmann, Emmanuel; Weber, Rainer; Blaser, Jürg (2015). Earlier switching from intravenous to oral antibiotics owing to electronic reminders. International Journal of Antimicrobial Agents, 46(4):428-433.

Abstract

Paper-based interventions have been shown to stimulate switching from intravenous (i.v.) to oral (p.o.) antibiotic therapies. Shorter i.v. durations are associated with a lower risk of iatrogenic infections as well as reduced workload and costs. The purpose of this study was to determine whether automated electronic reminders are able to promote earlier switching. In this controlled before-and-after study, an algorithm identified patients who were eligible for i.v.-to-p.o. switch 60h after starting i.v. antimicrobials. Reminders offering guidance on the re-assessment of initial i.v. therapy were displayed within the electronic health records in 12 units during the intervention period (year 2012). In contrast, no reminders were visible during the baseline period (2011) and in the control group (17 units). A total of 22863 i.v. antibiotic therapies were analysed; 6082 (26.6%) were switched to p.o.
THERAPY: In the intervention group, 757 courses of i.v. antibiotics were administered for a mean±standard deviation duration of 5.4±8.1 days before switching to p.o. antibiotics in the baseline period, and 794 courses for 4.5±5.5 days in the intervention period (P=0.004), corresponding to a 17.5% reduction of i.v. administration time. In contrast, in the control group the duration increased; 2240 i.v. antibiotics were administered for a mean duration of 4.0±5.9 days in the baseline period, and 2291 for 4.3±5.8 days in the intervention period (P=0.03). Electronic reminders fostered earlier i.v.-to-p.o. switches, thereby reducing the duration of initial i.v. therapies by nearly a day.

Abstract

Paper-based interventions have been shown to stimulate switching from intravenous (i.v.) to oral (p.o.) antibiotic therapies. Shorter i.v. durations are associated with a lower risk of iatrogenic infections as well as reduced workload and costs. The purpose of this study was to determine whether automated electronic reminders are able to promote earlier switching. In this controlled before-and-after study, an algorithm identified patients who were eligible for i.v.-to-p.o. switch 60h after starting i.v. antimicrobials. Reminders offering guidance on the re-assessment of initial i.v. therapy were displayed within the electronic health records in 12 units during the intervention period (year 2012). In contrast, no reminders were visible during the baseline period (2011) and in the control group (17 units). A total of 22863 i.v. antibiotic therapies were analysed; 6082 (26.6%) were switched to p.o.
THERAPY: In the intervention group, 757 courses of i.v. antibiotics were administered for a mean±standard deviation duration of 5.4±8.1 days before switching to p.o. antibiotics in the baseline period, and 794 courses for 4.5±5.5 days in the intervention period (P=0.004), corresponding to a 17.5% reduction of i.v. administration time. In contrast, in the control group the duration increased; 2240 i.v. antibiotics were administered for a mean duration of 4.0±5.9 days in the baseline period, and 2291 for 4.3±5.8 days in the intervention period (P=0.03). Electronic reminders fostered earlier i.v.-to-p.o. switches, thereby reducing the duration of initial i.v. therapies by nearly a day.

Citations

1 citation in Web of Science®
1 citation in Scopus®
Google Scholar™

Altmetrics

Downloads

8 downloads since deposited on 23 Nov 2015
8 downloads since 12 months
Detailed statistics

Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Infectious Diseases
04 Faculty of Medicine > Institute for Regenerative Medicine (IREM)
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:October 2015
Deposited On:23 Nov 2015 14:27
Last Modified:28 Jan 2017 08:00
Publisher:Elsevier
ISSN:0924-8579
Publisher DOI:https://doi.org/10.1016/j.ijantimicag.2015.06.013
PubMed ID:26293470

Download

Preview Icon on Download
Content: Published Version
Filetype: PDF - Registered users only
Size: 274kB
View at publisher
Preview Icon on Download
Preview
Content: Accepted Version
Filetype: PDF
Size: 513kB
Licence: Creative Commons: Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)

TrendTerms

TrendTerms displays relevant terms of the abstract of this publication and related documents on a map. The terms and their relations were extracted from ZORA using word statistics. Their timelines are taken from ZORA as well. The bubble size of a term is proportional to the number of documents where the term occurs. Red, orange, yellow and green colors are used for terms that occur in the current document; red indicates high interlinkedness of a term with other terms, orange, yellow and green decreasing interlinkedness. Blue is used for terms that have a relation with the terms in this document, but occur in other documents.
You can navigate and zoom the map. Mouse-hovering a term displays its timeline, clicking it yields the associated documents.

Author Collaborations