急性感染性结膜炎局部抗生素处方实践的闭环审计。

Andreas Katsimpris, Nafsika Voulgari, Nikolaos Georgiadis, Stylianos Kandarakis
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摘要

目的:初级保健部门对急性感染性结膜炎(AIC)患者抗生素处方指南建议的实施仍低于标准。我们的目的是评估临床审计对诊断为AIC的患者抗生素滴眼液处方循证指征的依从性的影响,在希腊西部的初级保健实践的背景下。方法:对目前AIC管理中抗生素处方实践进行回顾性审核。通过文献检索,根据AIC中抗生素处方的循证指征,结合与科室初级保健医生的讨论与合作,制定并实施AIC管理指南。然后,我们进行了前瞻性的重新审核,以评估指南在当地实施后AIC患者的管理。结果:指南实施前(2019年6月15日至2020年3月7日)共审核158例,指南实施后(2020年3月10日至2020年11月20日)共审核26例。第一次和第二次审核期间,抗生素处方的符合性从12.0%显著提高到84.6%。结论:在本研究中,随着指南的局部引入,临床审核显著改善了基层科室AIC患者外用抗生素的处方实践。缩写:AIC =急性感染性结膜炎。
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A closed-loop audit of the prescription practice of topical antibiotics for acute infective conjunctivitis.

Objective: 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. Methods: 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. Results: 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. Conclusions: 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. Abbreviations: AIC = acute infective conjunctivitis.

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