Page 17 - pest-POSTEN nr 3, 2018

Side 17 -pest-POSTEN

Conclusions: Antibiotic stewardship is recently adherence to guidelines and implementation outcomes
implemented in Norwegian hospitals. The goal of 30% according to locally defined targets before and after
reduction in selected broad spectrum antibiotics by end interventions were implemented.
2020 may be within reach. Government involvement,
hospital management commitment and specific goals Results: 1802 patient stays were included. Pneumonia
for change are likely to be the success factors. was the most frequent indication for treatment (25.6%),
followed by exacerbation of chronic obstructive
pulmonary disease (COPD) (19.7%) and
sepsis (15.9%). Adherence to guidelines had
an absolute increase from 60 to 66% for the
intervention wards across specialties and
diagnoses, compared to no change for control
wards. Pulmonary wards had a higher absolute
increase in adherence with 13% and 14% for
audit with feedback and academic detailing,
respectively. For the specific target identified
by one of the pulmonary wards, an intended
directional increase of 30% for the targeted
prescribing behaviour was seen.
Conclusions: Audit with feedback and academic
detailing improved antibiotic prescribing
practice, but the effect of interventions was
dependent on the context they were implemented in.
O0846 The effect of antibiotic stewardship
interventions with stakeholder involvement in Pulmonary wards achieved higher increase in adherent
multispecialty settings: a multicentre, cluster prescribing, independent of applied intervention.
Additional effects of interventions were seen when
randomized controlled intervention study. physicians discussed local prescribing behaviour and
Jannicke Slettli Wathne, Lars Kaare Kleppe, Stig
Harthug, Hege Salvesen Blix, Roy Nilsen, Andreas agreed on specific targets for changes in prescribing
Thelle, Dagfinn Lunde Markussen, Ottar Hope, Marion practice. Initial assessment of local prescribing practice
Iren Neteland, Ingrid Smith. should guide the focus of interventions and involvement
of prescribers in target setting.
Background: Antibiotic stewardship programs need
effective interventions and implementation strategies Brita Skodvin, også far KAS, presenterte en
to ensure responsible antibiotic prescribing in hospitals. poster kalt ”A diagnostic stewardship initiative:
Our objective was to determine the effect of audit microbiology testing and antibiotic precribing”.
with feedback and academic detailing on antibiotic Antibiotikabruk og mikrobiologiske prøvesvar
prescribing practice in multispecialty hospital wards for 668 medisinske pasienter ved Haukeland
and investigate additional effects of the implementation sykehus ble analysert og man at hele 72% av
strategies; local involvement of prescribers and target pas. hadde negative eller ikke-signinfikante svar.
setting. Svartiden var dessuten vurdert å være for lang.
Materials/methods: A multicentre, cluster randomized, Kun i 63 (9%) pasienter ble prøvesvar bruk til
controlled, intervention study was performed on ward å endre antibiotokaterapi. Disse noe nedslående
level within three specialities at three emergency resultatene er sikkert ikke atypisk for norske
care hospitals in Western Norway. The interventions sykehus, og gir bud både om at man bør ”gakke
audit with feedback and academic detailing were hen” og gjøre lignende evalueringer på egen
randomised to study wards and hospitals, based on
specialty. Included specialties were infectious diseases, arbeidsplass – og ikke minst søke å endre uheldig
pulmonary medicine and gastroenterology. Individual praksis der det lar seg gjøre. Mens vi venter på
patient data on antibiotic treatment, demographics mer og raskerte PoC testing og alle former for
and clinical outcomes were collected over 5 months. -genomics, som ECCMID bar bud om.
Antibiotic prescriptions were classified as adherent or
non-adherent to national guidelines based on indication Vel møtt neste april til 29. ECCMID i Amsterdam!
for treatment. Intervention outcome was analysed as ---***---