Service d'infectiologie, hôpital l'Archet-1, centre hospitalier universitaire de Nice, 151 route Saint-Antoine-de-Ginestière, Nice cedex 3, France.
Med Mal Infect. 2011 Oct;41(10):546-52. doi: 10.1016/j.medmal.2011.07.003. Epub 2011 Aug 19.
The study objectives were: (i) to design an intervention to improve the written documentation of empiric antibiotic prescriptions' reassessment; (ii) and to assess the impact of this intervention on the quality of prescriptions.
A prospective before and after 7-month intervention study in a medical ICU in a French teaching hospital, using interrupted time-series analysis. The intervention was made to improve the documentation of four process measures in medical records: antibiotic plan, reviewing the diagnosis, adapting to positive microbiological results, and IV-per os switch.
One hundred and fourteen antibiotic prescriptions were assessed, 62 before and 52 after the intervention. The reassessment of antibiotic prescriptions was more often documented in the ICU after the intervention (P=0.03 for sudden change). The prevalence of appropriate antibiotic prescriptions was not statistically different before and after the intervention, either for sudden change and/or linear trend.
A better documentation of antibiotic prescriptions' reassessment was achieved in this ICU, but it did not improve the quality of antibiotic prescriptions.
本研究旨在：（i）设计一项干预措施，以改进经验性抗生素处方重新评估的书面记录；（ii）评估该干预措施对处方质量的影响。
这是一项在法国教学医院的重症监护病房进行的前瞻性、干预前后 7 个月的研究，采用了中断时间序列分析。干预措施旨在改进病历中四个过程措施的记录：抗生素方案、重新评估诊断、根据阳性微生物学结果进行调整，以及静脉-口服转换。
共评估了 114 份抗生素处方，干预前 62 份，干预后 52 份。干预后 ICU 中更频繁地记录了抗生素处方的重新评估（干预后的突然变化 P=0.03）。干预前后，适当的抗生素处方的流行率无论是在突然变化还是线性趋势方面均无统计学差异。
该重症监护病房的抗生素处方重新评估记录有所改善，但并未改善抗生素处方的质量。
