Appropriateness of antibiotic therapy on weekends vs weekdays

Abstract number: 1733_1596

Bishara J., Hershkovitz D., Pitlik S.

Background: Several recent reports have raised concerns about the adequacy of medical care provided by hospitals on weekends. Antibiotic resistance is an emerging and universal problem and one of its major contributors is the inappropriate prescription of antibiotics.

Objective: To compare the appropriateness of antibiotic treatment prescribed in an emergency department (ED) of a tertiary medical centre on weekdays and weekends.

Methods: During a one month period medical charts of 1029 ED visits, who were discharged from ED were reviewed. Data of patients that were discharged with antibiotics was blindly evaluated by two infectious diseases specialists, and an ``appropriateness score'' was given to the antibiotic prescription.

Results: Antibiotics were prescribed at discharge for182 (17.7%) patients. The appropriateness score was significantly better at the beginning of the week and declined progressively toward the weekend (p = 0.025). Appropriateness scores were higher for the surgical and urological wings (p = 0.011), and for diagnoses of pneumonia and urinary tract infection (p = 0.005). Time of the day, patients age and sex did not have a significant effect on the appropriateness score.

Conclusions: During the week, there is a progressive decay in the appropriateness of antibiotic prescriptions in the ED. More studies are needed to clarify measures improving appropriate antibiotic therapy in weekends.