First Ophthalmology Department, "G. Gennimatas" Hospital, Athens, Greece; National and Kapodistrian University of Athens, Athens, Greece.
Department of Family and Community Medicine, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece; "Ippokrateio" General Hospital of Athens, Athens, Greece.
Rom J Ophthalmol. 2023 Jan-Mar;67(1):41-45. doi: 10.22336/rjo.2023.7.
The implementation of guideline recommendations for antibiotics prescription for the management of patients with acute infective conjunctivitis (AIC) in primary care departments remains below par. Our objective was to assess the impact of clinical audit on adherence to evidence-based indications for prescription of antibiotic eye drops in patients diagnosed with AIC, in the setting of a primary care practice in western Greece. We conducted a retrospective audit to evaluate the current prescription practice of antibiotics for the management of AIC. Following evidence-based indications for the prescription of antibiotics in AIC through literature search, and in combination with discussion and collaboration with the primary care doctors of our department, we formulated and implemented guidelines for the management of AIC. We then performed a prospective re-audit to assess the management of patients with AIC after local implementation of the guidelines. A total of 158 cases were audited in the first cycle before the introduction of the guidelines, from 15th June 2019 to 7th March 2020, and 26 cases after, from 10th March 2020 to 20th November 2020. The compliance with the guidelines regarding antibiotics prescription was significantly improved from 12.0% to 84.6% between the first and the second cycles of audit. In this study, with the local introduction of guidelines, clinical audit significantly improved the prescription practice of topical antibiotics in patients with AIC in a primary care department. AIC = acute infective conjunctivitis.
在初级保健部门，指南推荐的抗生素处方用于治疗急性传染性结膜炎 (AIC) 的实施情况仍不理想。我们的目的是评估临床审计对遵守基于证据的 AIC 患者抗生素滴眼剂处方适应证的影响，该研究在希腊西部的一个初级保健实践中进行。
我们进行了回顾性审计，以评估当前 AIC 抗生素治疗的处方实践。通过文献检索确定了 AIC 抗生素处方的循证适应证，并结合与我科初级保健医生的讨论和协作，制定并实施了 AIC 管理指南。然后，我们进行了前瞻性再审计，以评估在当地实施指南后 AIC 患者的管理情况。
在指南引入前的第一个周期中，共审核了 158 例病例，时间为 2019 年 6 月 15 日至 2020 年 3 月 7 日，引入后第二个周期共审核了 26 例病例，时间为 2020 年 3 月 10 日至 11 月 20 日。与第一个周期相比，第二个周期的抗生素处方指南遵循率从 12.0%显著提高到 84.6%。
在这项研究中，通过引入当地指南，临床审计显著改善了初级保健部门 AIC 患者局部抗生素的处方实践。
