Thomas Platz, Peter Berlit, Christian Dohle, Helmut Fickenscher, Manju Guha, Volker Köllner, Axel Kramer, Rembert Koczulla, Axel Schlitt
The consensus-based guideline "SARS-CoV-2, COVID-19 and (early) rehabilitation" for Germany has two sections: In the first part, the guideline addresses infection protection-related procedures during the COVID-19 pandemic. In the second part, it provides practice recommendations for rehabilitation after COVID-19. The specific recommendations for rehabilitation after COVID-19 as issued by 13 German medical societies and two patient-representative organizations are presented together with general background information for their development.
{"title":"S2k-Guideline SARS-CoV-2, COVID-19 and (early) rehabilitation - a consensus-based guideline for Germany.","authors":"Thomas Platz, Peter Berlit, Christian Dohle, Helmut Fickenscher, Manju Guha, Volker Köllner, Axel Kramer, Rembert Koczulla, Axel Schlitt","doi":"10.3205/dgkh000438","DOIUrl":"https://doi.org/10.3205/dgkh000438","url":null,"abstract":"<p><p>The consensus-based guideline \"SARS-CoV-2, COVID-19 and (early) rehabilitation\" for Germany has two sections: In the first part, the guideline addresses infection protection-related procedures during the COVID-19 pandemic. In the second part, it provides practice recommendations for rehabilitation after COVID-19. The specific recommendations for rehabilitation after COVID-19 as issued by 13 German medical societies and two patient-representative organizations are presented together with general background information for their development.</p>","PeriodicalId":12738,"journal":{"name":"GMS Hygiene and Infection Control","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10227492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9922675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aim: Antibiotics are often prescribed for the treatment of various infections and prophylactic purposes in dental practice. Their improper use can cause microbial resistance to antibiotics, which poses a world-wide threat. The aim of this cross-sectional study was to evaluate the knowledge and attitudes of dentists and dentistry students about antibiotic prescription practices for prophylaxis and the treatment of dental infections in pediatric patients.
Methods: A questionnaire was e-mailed to 2,100 dentists and 300 senior dentistry students. The questionnaire was filled out by the participants within a 2-month period (May-June 2020). A 30-point scoring system was developed to assess the knowledge levels of the dentists according to the guidelines. Descriptive statistical analyses were performed. One-way ANOVA test and the Chi-Squared test were used to compare qualitative variables.
Results: The response rate was found to be 24.2% for dentists and 49% for senior dentistry students. 19.4% of the participants were found to be moderately knowledgeable and 80.6% of them were highly knowledgeable. Students' knowledge scores were found to be higher than the general dentists and other specialists (p<0.05). There was no significant difference between students and pedodontists.
Conclusion: Dentists were found to have sufficient knowledge about the usage of antibiotics in children, but there is still a lack of information about circumstances under which antibiotics should not be prescribed. Dentists and dentistry students should attend continuing education programs to keep their information up-to-date and should also prescribe antibiotics in adherence with the current guidelines to prevent antibiotic resistance.
{"title":"Antibiotic prescribing practices for prophylaxis and therapy of oral/dental infections in pediatric patients - results of a cross-sectional study in Turkey.","authors":"Belen Sirinoglu Capan, Canan Duman, Elif Ece Kalaoglu","doi":"10.3205/dgkh000437","DOIUrl":"https://doi.org/10.3205/dgkh000437","url":null,"abstract":"<p><strong>Aim: </strong>Antibiotics are often prescribed for the treatment of various infections and prophylactic purposes in dental practice. Their improper use can cause microbial resistance to antibiotics, which poses a world-wide threat. The aim of this cross-sectional study was to evaluate the knowledge and attitudes of dentists and dentistry students about antibiotic prescription practices for prophylaxis and the treatment of dental infections in pediatric patients.</p><p><strong>Methods: </strong>A questionnaire was e-mailed to 2,100 dentists and 300 senior dentistry students. The questionnaire was filled out by the participants within a 2-month period (May-June 2020). A 30-point scoring system was developed to assess the knowledge levels of the dentists according to the guidelines. Descriptive statistical analyses were performed. One-way ANOVA test and the Chi-Squared test were used to compare qualitative variables.</p><p><strong>Results: </strong>The response rate was found to be 24.2% for dentists and 49% for senior dentistry students. 19.4% of the participants were found to be moderately knowledgeable and 80.6% of them were highly knowledgeable. Students' knowledge scores were found to be higher than the general dentists and other specialists (p<0.05). There was no significant difference between students and pedodontists.</p><p><strong>Conclusion: </strong>Dentists were found to have sufficient knowledge about the usage of antibiotics in children, but there is still a lack of information about circumstances under which antibiotics should not be prescribed. Dentists and dentistry students should attend continuing education programs to keep their information up-to-date and should also prescribe antibiotics in adherence with the current guidelines to prevent antibiotic resistance.</p>","PeriodicalId":12738,"journal":{"name":"GMS Hygiene and Infection Control","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10227498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9939413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marcelo Caliman Sato, Emilene Cristine Izu Nakamura Pietro, Lucas Marques da Costa Alves, Axel Kramer, Paulo Sérgio da Silva Santos
Immunosuppression and critical illnesses in combination with ecological imbalance open the door for novel opportunistic fungal infections, as in case of Candida (C). auris. C. auris has emerged globally as a multidrug-resistant yeast, causing infections and outbreaks in health care facilities. This narrative review discusses the properties of the yeast, the development of the epidemiological situation, the nosocomial spread and causes for nosocomial outbreaks triggered by C. auris in the hospital environment, and summarizes international recommendations for infection control, supplemented by suggestions on diagnostic, screening and antibiotic stewardship.
{"title":"Candida auris: a novel emerging nosocomial pathogen - properties, epidemiological situation and infection control.","authors":"Marcelo Caliman Sato, Emilene Cristine Izu Nakamura Pietro, Lucas Marques da Costa Alves, Axel Kramer, Paulo Sérgio da Silva Santos","doi":"10.3205/dgkh000444","DOIUrl":"https://doi.org/10.3205/dgkh000444","url":null,"abstract":"<p><p>Immunosuppression and critical illnesses in combination with ecological imbalance open the door for novel opportunistic fungal infections, as in case of <i>Candida (C). auris</i>. <i>C. auris</i> has emerged globally as a multidrug-resistant yeast, causing infections and outbreaks in health care facilities. This narrative review discusses the properties of the yeast, the development of the epidemiological situation, the nosocomial spread and causes for nosocomial outbreaks triggered by <i>C. auris</i> in the hospital environment, and summarizes international recommendations for infection control, supplemented by suggestions on diagnostic, screening and antibiotic stewardship.</p>","PeriodicalId":12738,"journal":{"name":"GMS Hygiene and Infection Control","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10486814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10220034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To prevent surgical site infections (SSIs), a three-step model is proposed, which integrates perioperative measures, multidisciplinary collaboration, and continuous quality improvement (CQI) initiatives.
{"title":"Three steps to reduction surgical site infection: presentation of a comprehensive model.","authors":"Saeid Amini Rarani, Axel Kramer","doi":"10.3205/dgkh000443","DOIUrl":"https://doi.org/10.3205/dgkh000443","url":null,"abstract":"<p><p>To prevent surgical site infections (SSIs), a three-step model is proposed, which integrates perioperative measures, multidisciplinary collaboration, and continuous quality improvement (CQI) initiatives.</p>","PeriodicalId":12738,"journal":{"name":"GMS Hygiene and Infection Control","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10486815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10225198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nader Aghakhani, Bahman Alinezhad, Mehdi Azami, Saied Amini Rarani
Dear editor, The COVID-19 global pandemic caused interruptions in the admission of patients to the emergency unit and a reduction in the incidence of optional surgeries, having a substantial effect on surgical practice. On the other hand, the effects of COVID-19 on surgical professional problems, including the danger of intraoperative viral transmission, illness among health-care staff, and other influences on surgical training, have been discussed many times [1]. The current need for ventilators, staff, and space is a limiting factor for the deployment of surgical resources during the pandemic training, to the point where the provision of essential surgery is being compromised in multiple areas, such as operating rooms, the number of surgeons, and operating staff.Aroung the world, many people who are suffering from surgical complaints are affected both immediately and over time by the strain these limitations impose on the system [2]. Patients should be thoroughly observed after surgery, since there are signs that undetected COVID-19 may make recovery more complicated. Pulmonary complica-
{"title":"Acute care surgery model in the COVID-19 pandemic era.","authors":"Nader Aghakhani, Bahman Alinezhad, Mehdi Azami, Saied Amini Rarani","doi":"10.3205/dgkh000442","DOIUrl":"https://doi.org/10.3205/dgkh000442","url":null,"abstract":"Dear editor, The COVID-19 global pandemic caused interruptions in the admission of patients to the emergency unit and a reduction in the incidence of optional surgeries, having a substantial effect on surgical practice. On the other hand, the effects of COVID-19 on surgical professional problems, including the danger of intraoperative viral transmission, illness among health-care staff, and other influences on surgical training, have been discussed many times [1]. The current need for ventilators, staff, and space is a limiting factor for the deployment of surgical resources during the pandemic training, to the point where the provision of essential surgery is being compromised in multiple areas, such as operating rooms, the number of surgeons, and operating staff.Aroung the world, many people who are suffering from surgical complaints are affected both immediately and over time by the strain these limitations impose on the system [2]. Patients should be thoroughly observed after surgery, since there are signs that undetected COVID-19 may make recovery more complicated. Pulmonary complica-","PeriodicalId":12738,"journal":{"name":"GMS Hygiene and Infection Control","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10486874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10225200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Axel Kramer, Hicham Benkhai, Christian Jäkel, Paula Zwicker
The approval of ethanol by the Biocidal Products Regulation has been under evaluation since 2007 due to controversial opinions on the risk assessment. Because of this critical situation, 2022 a memorandum was published to verify whether the use of ethanol for hand antisepsis poses any hazard. On the basis of the memorandum a toxicological evaluation of ethanol-based hand rubs is given.
{"title":"Ethanol is indispensable for virucidal hand antisepsis and without toxic risks in daily use.","authors":"Axel Kramer, Hicham Benkhai, Christian Jäkel, Paula Zwicker","doi":"10.3205/dgkh000428","DOIUrl":"https://doi.org/10.3205/dgkh000428","url":null,"abstract":"<p><p>The approval of ethanol by the Biocidal Products Regulation has been under evaluation since 2007 due to controversial opinions on the risk assessment. Because of this critical situation, 2022 a memorandum was published to verify whether the use of ethanol for hand antisepsis poses any hazard. On the basis of the memorandum a toxicological evaluation of ethanol-based hand rubs is given.</p>","PeriodicalId":12738,"journal":{"name":"GMS Hygiene and Infection Control","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9978451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10849191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dirk Boecker, Zhentian Zhang, Roland Breves, Felix Herth, Axel Kramer, Clemens Bulitta
The objective is to provide a comprehensive overview of the rapidly developing field of the current state of research on in vivo use of hypochlorous acid (HOCl) to aid infection prevention and control, including naso-pharyngeal, alveolar, topical, and systemic HOCl applications. Also, examples are provided of dedicated applications in COVID-19. A brief background of HOCl's biological and chemical specifics and its physiological role in the innate immune system is provided to understand the effect of in vivo applications in the context of the body's own physiological defense mechanisms.
{"title":"Antimicrobial efficacy, mode of action and in vivo use of hypochlorous acid (HOCl) for prevention or therapeutic support of infections.","authors":"Dirk Boecker, Zhentian Zhang, Roland Breves, Felix Herth, Axel Kramer, Clemens Bulitta","doi":"10.3205/dgkh000433","DOIUrl":"https://doi.org/10.3205/dgkh000433","url":null,"abstract":"<p><p>The objective is to provide a comprehensive overview of the rapidly developing field of the current state of research on <i>in vivo</i> use of hypochlorous acid (HOCl) to aid infection prevention and control, including naso-pharyngeal, alveolar, topical, and systemic HOCl applications. Also, examples are provided of dedicated applications in COVID-19. A brief background of HOCl's biological and chemical specifics and its physiological role in the innate immune system is provided to understand the effect of <i>in vivo</i> applications in the context of the body's own physiological defense mechanisms.</p>","PeriodicalId":12738,"journal":{"name":"GMS Hygiene and Infection Control","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10073986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9273559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: The aim of this study was to determine the acceptance of Covid-19 vaccine among the Turkish adult population.
Methods: A total of 2023 persons participated in this cross-sectional study between October 2020 and January 2021. The questionnaire, which was delivered via social media, was filled out by the participants over "Google Forms".
Results: Questionnaire results showed that 68.7% of the participants might agree to vaccinated against COVID-19. According to univariate analysis, the age group of 50-59, urban residents, healthcare workers, non-smokers, and those with chronic diseases, those who were vaccinated against influenza, pneumonia, and tetanus were all willing to be vaccinated against COVID-19.
Conclusions: It is very important to determine a community's willingness to be vaccinated against COVID-19 so that interventions can be made to solve related problems. Risk of exposure and importance of Prevention play a critical role in vaccination acceptance.
{"title":"Covid-19 vaccination acceptance and hesitancy among the Turkish adult population.","authors":"Sükran Köse, Aliye Mandiracioglu, Yusuf Özbel, Seheray Zeyrek, Didem Dereli Akdeniz, Hossein Samadi Kafil","doi":"10.3205/dgkh000427","DOIUrl":"https://doi.org/10.3205/dgkh000427","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to determine the acceptance of Covid-19 vaccine among the Turkish adult population.</p><p><strong>Methods: </strong>A total of 2023 persons participated in this cross-sectional study between October 2020 and January 2021. The questionnaire, which was delivered via social media, was filled out by the participants over \"Google Forms\".</p><p><strong>Results: </strong>Questionnaire results showed that 68.7% of the participants might agree to vaccinated against COVID-19. According to univariate analysis, the age group of 50-59, urban residents, healthcare workers, non-smokers, and those with chronic diseases, those who were vaccinated against influenza, pneumonia, and tetanus were all willing to be vaccinated against COVID-19.</p><p><strong>Conclusions: </strong>It is very important to determine a community's willingness to be vaccinated against COVID-19 so that interventions can be made to solve related problems. Risk of exposure and importance of Prevention play a critical role in vaccination acceptance.</p>","PeriodicalId":12738,"journal":{"name":"GMS Hygiene and Infection Control","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9978452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9395427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Irene Krämer, Rangmar Goelz, Christian Gille, Christoph Härtel, Rachel Müller, Thorsten Orlikowsky, Brar Piening, Sebastian Schubert, Arne Simon, Katharina Wolf, Bianka Rösner, Martin Exner
This position paper, developed by an interdisciplinary expert group of neonatologists, paediatric infectious disease physicians, clinical pharmacists and specialists for the prevention and control of nosocomial infections, describes the "Good handling practice of medicines parenterally administered to patients on NICUs". It takes equal account of patient safety and the specialties of neonatal intensive care regarding feasibility and proportionality. The overall concept is perceived as a "learning system", in which open communication within the health-care team relating to medication errors and critical incidents enables continuous development and improvement to ensure patient safety. In our opinion, pharmacists, who are responsible for the supply of ready-to-administer parenteral medicinal products for neonatal intensive care patients, as well as the hygiene staff responsible on site are integral parts of the interdisciplinary treatment team. Risks of the current clinical practice of parenteral treatment of NICU patients are discussed in detail and recommendations for safety-relevant procedures are given.
{"title":"Good handling practice of parenterally administered medicines in neonatal intensive care units - position paper of an interdisciplinary working group.","authors":"Irene Krämer, Rangmar Goelz, Christian Gille, Christoph Härtel, Rachel Müller, Thorsten Orlikowsky, Brar Piening, Sebastian Schubert, Arne Simon, Katharina Wolf, Bianka Rösner, Martin Exner","doi":"10.3205/dgkh000436","DOIUrl":"https://doi.org/10.3205/dgkh000436","url":null,"abstract":"<p><p>This position paper, developed by an interdisciplinary expert group of neonatologists, paediatric infectious disease physicians, clinical pharmacists and specialists for the prevention and control of nosocomial infections, describes the \"Good handling practice of medicines parenterally administered to patients on NICUs\". It takes equal account of patient safety and the specialties of neonatal intensive care regarding feasibility and proportionality. The overall concept is perceived as a \"learning system\", in which open communication within the health-care team relating to medication errors and critical incidents enables continuous development and improvement to ensure patient safety. In our opinion, pharmacists, who are responsible for the supply of ready-to-administer parenteral medicinal products for neonatal intensive care patients, as well as the hygiene staff responsible on site are integral parts of the interdisciplinary treatment team. Risks of the current clinical practice of parenteral treatment of NICU patients are discussed in detail and recommendations for safety-relevant procedures are given.</p>","PeriodicalId":12738,"journal":{"name":"GMS Hygiene and Infection Control","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10227494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9939406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Simone Scheithauer, Britta Karasimos, David Manamayil, Helga Häfner, Karl Lewalter, Karl Mischke, Bernhard Heintz, Frank Tacke, David Brücken, Christian Lüring, Christoph Heidenhain, Lachmandath Tewarie, Ralf-Dieter Hilgers, Sebastian W Lemmen
Aim: To evaluate general shortcomings and faculty-specific pitfalls as well as to improve antibiotic prescription quality (ABQ) in non-ICU wards, we performed a prospective cluster trial.
Methods: An infectious-disease (ID) consulting service performed a prospective investigation consisting of three 12-week phases with point prevalence evaluation conducted once per week (=36 evaluations in total) at seven non-ICU wards, followed by assessment of sustainability (weeks 37-48). Baseline evaluation (phase 1) defined multifaceted interventions by identifying the main shortcomings. Then, to distinguish intervention from time effects, the interventions were performed in four wards, and the 3 remaining wards served as controls; after assessing effects (phase 2), the same interventions were performed in the remaining wards to test the generalizability of the interventions (phase 3). The prolonged responses after all interventions were then analyzed in phase 4. ABQ was evaluated by at least two ID specialists who assessed the indication for therapy, the adherence to the hospital guidelines for empirical therapy, and the overall antibiotic prescription quality.
Results: In phase 1, 406 of 659 (62%) patients cases were adequately treated with antibiotics; the main reason for inappropriate prescription was the lack of an indication (107/253; 42%). The antibiotic prescription quality (ABQ) significantly increased, reaching 86% in all wards after the focused interventions (502/584; nDf=3, ddf=1,697, F=6.9, p=0.0001). In phase 2 the effect was only seen in wards that already participated in interventions (248/347; 71%). No improvement was seen in wards that received interventions only after phase 2 (189/295; 64%). A given indication significantly increased from about 80% to more than 90% (p<.0001). No carryover effects were observed.
Discussion: ABQ can be improved significantly by intervention bundles with apparent sustainable effects.
{"title":"A prospective cluster trial to increase antibiotic prescription quality in seven non-ICU wards.","authors":"Simone Scheithauer, Britta Karasimos, David Manamayil, Helga Häfner, Karl Lewalter, Karl Mischke, Bernhard Heintz, Frank Tacke, David Brücken, Christian Lüring, Christoph Heidenhain, Lachmandath Tewarie, Ralf-Dieter Hilgers, Sebastian W Lemmen","doi":"10.3205/dgkh000440","DOIUrl":"https://doi.org/10.3205/dgkh000440","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate general shortcomings and faculty-specific pitfalls as well as to improve antibiotic prescription quality (ABQ) in non-ICU wards, we performed a prospective cluster trial.</p><p><strong>Methods: </strong>An infectious-disease (ID) consulting service performed a prospective investigation consisting of three 12-week phases with point prevalence evaluation conducted once per week (=36 evaluations in total) at seven non-ICU wards, followed by assessment of sustainability (weeks 37-48). Baseline evaluation (phase 1) defined multifaceted interventions by identifying the main shortcomings. Then, to distinguish intervention from time effects, the interventions were performed in four wards, and the 3 remaining wards served as controls; after assessing effects (phase 2), the same interventions were performed in the remaining wards to test the generalizability of the interventions (phase 3). The prolonged responses after all interventions were then analyzed in phase 4. ABQ was evaluated by at least two ID specialists who assessed the indication for therapy, the adherence to the hospital guidelines for empirical therapy, and the overall antibiotic prescription quality.</p><p><strong>Results: </strong>In phase 1, 406 of 659 (62%) patients cases were adequately treated with antibiotics; the main reason for inappropriate prescription was the lack of an indication (107/253; 42%). The antibiotic prescription quality (ABQ) significantly increased, reaching 86% in all wards after the focused interventions (502/584; nDf=3, ddf=1,697, F=6.9, p=0.0001). In phase 2 the effect was only seen in wards that already participated in interventions (248/347; 71%). No improvement was seen in wards that received interventions only after phase 2 (189/295; 64%). A given indication significantly increased from about 80% to more than 90% (p<.0001). No carryover effects were observed.</p><p><strong>Discussion: </strong>ABQ can be improved significantly by intervention bundles with apparent sustainable effects.</p>","PeriodicalId":12738,"journal":{"name":"GMS Hygiene and Infection Control","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10316282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9799644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}