A controlled intervention study to improve antibiotic use in a Russian paediatric hospital

Abstract number: 1134_01_130

Berild D., Abrahamsen T.G., Andresen S., Bjørløw E., Mintchenko S., Kossenko I., Kubar O., Lelek M., Pyasetskaya M., Ringertz S., Sysenko G.

Objectives:  

Antibiotic use is increasing in Eastern Europe promoting antibiotic resistance. There have been few reports on antibiotic use from Russian hospitals. We aimed to implement guidelines for rational antibiotic use in a Russian 600-bed paediatric hospital.

Methods:  

We performed a prospective controlled intervention study to improve antibiotic use. One dep. of gastroenterological infections and one dep. of respiratory tract served as intervention deps. One dep. of gastroenterological infection and one dep. of respiratory tract infections served as control departments. During October through December 2002 demographic data, diagnoses, antibiotic allergy, bacteriological findings, antibiotic use, duration of stay, costs, and outcome were recorded in all patients. Thereafter we conducted repeated whole day meetings where rational antibiotic policy was promoted. Written consensus guidelines for rational antibiotic use based on the local resistance pattern were developed and implemented. The same data as in the baseline period were recorded during October though December 2003.

Results:  

At the intervention department of gastroenterological infections the percentage of patients treated with antibiotics decreased from 96% to 50%. At the intervention department of respiratory tract infections the percentage of patients receiving antibiotics decreased from 91% to 69%. There was a slight reduction in antibiotic use at one control dep. There was no increase in mortality or duration of hospital stay.

Conclusion:  

There was a significant decrease in antibiotic use and costs at the intervention departments and a slight reduction at one control department. The decrease of antibiotic use did not compromise quality of patient care.