Directorate of Infection Control, Ministry of Health, Al-Shamiya, Kuwait City, Kuwait.
Med Princ Pract. 2012;21(4):310-7. doi: 10.1159/000334769. Epub 2012 Jan 12.
To audit physicians' adherence to the local antibiotic policy guidelines in government hospitals in Kuwait.
The study was a retrospective review of patient records in nine hospitals between July 1 and December 31, 2008. Clinical notes and medication charts of the latest hospital admissions were checked for antibiotic prescribing. On the audit form, aspects of the prescribed antibiotic were benchmarked to the hospital antibiotic policy guidelines to evaluate adherence.
Of 2,232 reviewed records, 1,112 (49.8%) patients had 1,528 antibiotic prescriptions. Patients who received antibiotics were significantly younger than those who did not (median age: 26.3 vs. 29.8 years, p < 0.001) and their hospital stay was significantly longer (median: 4 vs. 2 days, p < 0.001). The choice of an antibiotic was appropriate and matched the policy in 806 (52.7%) prescriptions. Of such appropriate antibiotics, adherence to route of administration was observed in 768/806 (95.3%), to dose in 758 (94%), to frequency in 746 (92.6%) and to duration in 608 (75.4%). Full adherence to all aspects of antibiotic choice, dose, route, frequency and duration was achieved in 464 (30.4%) prescriptions. In 382 (25%), the antibiotics administered were not indicated.
There was low adherence to the local antibiotic policy guidelines. Physicians' antibiotic prescribing practices should be optimized. Adherence to, and update of, the policy is recommended.
审计科威特政府医院医生对当地抗生素政策指南的遵守情况。
本研究是对 2008 年 7 月 1 日至 12 月 31 日期间 9 家医院的患者记录进行的回顾性审查。检查最新住院患者的临床记录和用药图表，以查看抗生素的开具情况。在审核表上，将所开抗生素的各个方面与医院抗生素政策指南进行基准比较，以评估遵守情况。
在审查的 2232 份记录中，有 1112 名（49.8%）患者有 1528 份抗生素处方。接受抗生素治疗的患者明显比未接受抗生素治疗的患者年轻（中位数年龄：26.3 岁比 29.8 岁，p < 0.001），住院时间明显更长（中位数：4 天比 2 天，p < 0.001）。抗生素的选择是合适的，与政策相符，有 806 份（52.7%）处方。在这些合适的抗生素中，观察到 768/806（95.3%）例患者的给药途径、758/806（94%）例患者的剂量、746/806（92.6%）例患者的给药频率和 608/806（75.4%）例患者的治疗持续时间都符合规定。在 464 份（30.4%）处方中完全符合抗生素选择、剂量、途径、频率和持续时间的所有方面。在 382 份（25%）处方中，使用的抗生素没有指征。
对当地抗生素政策指南的遵守程度较低。应优化医生的抗生素处方实践。建议遵守并更新政策。
