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Article: Clinical and economic impact of an antibiotics stewardship programme in a regional hospital in Hong Kong

TitleClinical and economic impact of an antibiotics stewardship programme in a regional hospital in Hong Kong
Authors
Issue Date2008
PublisherB M J Publishing Group. The Journal's web site is located at http://qhc.bmjjournals.com/
Citation
Quality And Safety In Health Care, 2008, v. 17 n. 5, p. 387-392 How to Cite?
AbstractBackground: Inappropriate use of antibiotics is one of the important factors attributing to emergence of drug- resistant pathogens. Infection with multidrug-resistant pathogens adversely affects quality of medical care. Context: Queen Elizabeth Hospital, an 1800-bed acute service hospital in Hong Kong. Antibiotics are commonly prescribed for treating acute infections. Key measures for improvement: Reduce inappropriate prescription of broad-spectrum antibiotics and overall antibiotic prescription through implementation of a multidisciplinary antibiotics stewardship programme (ASP). Strategies for change: A multidisciplinary programme involving policy and guideline formulation, education and feedback, monthly antibiotic consumption and cost monitoring, antimicrobial susceptibility pattern reporting and concurrent feedbacks for commonly prescribed broad-spectrum antibiotics was implemented in 2004. Predefined logistics to prescribe "restricted" antibiotics were formulated and implemented with collaborative efforts from clinical and non-clinical departments. The programme was supported by management at department and hospital levels. Effects of change: Broad-spectrum antibiotics were prescribed inappropriately in 28.9% (n = 192) clinical scenarios. The ASP reduced the restricted and total antibiotic consumption as well as the antibiotics-related costs. Predefined clinical outcomes were not adversely affected. Economic analysis suggested that the extra human cost in running ASP could be offset by savings from antibiotic expenditure. Lessons learned: It is cost-effective to implement a multidisciplinary ASP in acute service hospitals as the programme reduces antibiotic consumption and results in overall cost savings. The quality of medical care is not jeopardised as the important clinical outcomes are not adversely affected. The generalisability and sustainability of ASPs in other clinical contexts warrant further studies to ensure the continuous success of this programme.
Persistent Identifierhttp://hdl.handle.net/10722/60326
ISSN
2012 Impact Factor: 2.16
2013 SCImago Journal Rankings: 1.108
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorNg, CKen_HK
dc.contributor.authorWu, TCen_HK
dc.contributor.authorChan, WMJen_HK
dc.contributor.authorLeung, YSWen_HK
dc.contributor.authorPli, CKen_HK
dc.contributor.authorTsang, DNCen_HK
dc.contributor.authorLeung, GMen_HK
dc.date.accessioned2010-05-31T04:08:20Z-
dc.date.available2010-05-31T04:08:20Z-
dc.date.issued2008en_HK
dc.identifier.citationQuality And Safety In Health Care, 2008, v. 17 n. 5, p. 387-392en_HK
dc.identifier.issn1475-3898en_HK
dc.identifier.urihttp://hdl.handle.net/10722/60326-
dc.description.abstractBackground: Inappropriate use of antibiotics is one of the important factors attributing to emergence of drug- resistant pathogens. Infection with multidrug-resistant pathogens adversely affects quality of medical care. Context: Queen Elizabeth Hospital, an 1800-bed acute service hospital in Hong Kong. Antibiotics are commonly prescribed for treating acute infections. Key measures for improvement: Reduce inappropriate prescription of broad-spectrum antibiotics and overall antibiotic prescription through implementation of a multidisciplinary antibiotics stewardship programme (ASP). Strategies for change: A multidisciplinary programme involving policy and guideline formulation, education and feedback, monthly antibiotic consumption and cost monitoring, antimicrobial susceptibility pattern reporting and concurrent feedbacks for commonly prescribed broad-spectrum antibiotics was implemented in 2004. Predefined logistics to prescribe "restricted" antibiotics were formulated and implemented with collaborative efforts from clinical and non-clinical departments. The programme was supported by management at department and hospital levels. Effects of change: Broad-spectrum antibiotics were prescribed inappropriately in 28.9% (n = 192) clinical scenarios. The ASP reduced the restricted and total antibiotic consumption as well as the antibiotics-related costs. Predefined clinical outcomes were not adversely affected. Economic analysis suggested that the extra human cost in running ASP could be offset by savings from antibiotic expenditure. Lessons learned: It is cost-effective to implement a multidisciplinary ASP in acute service hospitals as the programme reduces antibiotic consumption and results in overall cost savings. The quality of medical care is not jeopardised as the important clinical outcomes are not adversely affected. The generalisability and sustainability of ASPs in other clinical contexts warrant further studies to ensure the continuous success of this programme.en_HK
dc.languageengen_HK
dc.publisherB M J Publishing Group. The Journal's web site is located at http://qhc.bmjjournals.com/en_HK
dc.relation.ispartofQuality and Safety in Health Careen_HK
dc.rightsQuality and Safety in Health Care. Copyright © B M J Publishing Group.en_HK
dc.subject.meshAgeden_HK
dc.subject.meshAnti-Bacterial Agents - economics - therapeutic useen_HK
dc.subject.meshComorbidityen_HK
dc.subject.meshCost Savingsen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshHealth Plan Implementationen_HK
dc.subject.meshHong Kongen_HK
dc.subject.meshHospital Bed Capacity, 500 and overen_HK
dc.subject.meshHospitals, Public - economics - statistics & numerical dataen_HK
dc.subject.meshHumansen_HK
dc.subject.meshIntensive Care Units - utilizationen_HK
dc.subject.meshLength of Stay - statistics & numerical dataen_HK
dc.subject.meshLogistic Modelsen_HK
dc.subject.meshMaleen_HK
dc.subject.meshPhysician's Practice Patterns - economicsen_HK
dc.subject.meshProgram Evaluationen_HK
dc.subject.meshRisk Managementen_HK
dc.subject.meshUnnecessary Procedures - economics - statistics & numerical dataen_HK
dc.titleClinical and economic impact of an antibiotics stewardship programme in a regional hospital in Hong Kongen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1475-3898&volume=17&spage=387&epage=392&date=2008&atitle=Clinical+and+economic+impact+of+an+antibiotics+stewardship+programme+in+a+regional+hospital+in+Hong+Kongen_HK
dc.identifier.emailLeung, GM:gmleung@hku.hken_HK
dc.identifier.authorityLeung, GM=rp00460en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1136/qshc.2007.023267en_HK
dc.identifier.pmid18842981-
dc.identifier.scopuseid_2-s2.0-61449195279en_HK
dc.identifier.hkuros155230en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-61449195279&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume17en_HK
dc.identifier.issue5en_HK
dc.identifier.spage387en_HK
dc.identifier.epage392en_HK
dc.identifier.isiWOS:000259898800016-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridNg, CK=36747474400en_HK
dc.identifier.scopusauthoridWu, TC=14120508600en_HK
dc.identifier.scopusauthoridChan, WMJ=7403918030en_HK
dc.identifier.scopusauthoridLeung, YSW=35234128800en_HK
dc.identifier.scopusauthoridPli, CK=26040958100en_HK
dc.identifier.scopusauthoridTsang, DNC=7005609132en_HK
dc.identifier.scopusauthoridLeung, GM=7007159841en_HK

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