Table 4.
Local targets set by study intervention wards and outcome for targeted change in prescribing practice
| Hospital | Ward | Intervention | Targets | Outcome |
|---|---|---|---|---|
| A | Pulmonary medicine | Audit with feedback | Increase the use of Penicillin G 2 mill IU × 4 to treat pneumonia (CAP) and infectious COPD exacerbations | 30% increase (p < 0.001)a |
| A | Gastroenterology | Academic detailing | Reduce ciprofloxacin use for inflammatory bowel disease, and shift to Co-trimoxazol (indication outside national antibiotic guideline) |
Too few patients with targeted indication to assess outcome by indication. Assessed by use of sales statistics. Reduction in use of Ciprofloxacin at 3, 6, 12 and 18 months following the intervention (not significant)b (Appendix Table 6). |
| B | Pulmonary medicine | Academic detailing | Target areas discussed: - Reevaluation of initiated treatment on arrival to ward and - after 48–72 h - Increase use of CRB-65 and antibiotic guideline |
Consensus on 1–2 targets not achieved |
| B | Infectious diseases | Audit with feedback | Target areas discussed: - Increase use of Penicillin G 2 mill × 4 to treat infectious COPD exacerbations - Reassess length of iv-antibiotics for patients with osteomyelitis - Increase consultants presence in the emergency room to increase guidelines adherence on admission - Reevaluation of treatment during the patient stay |
Consensus on 1–2 targets not achieved |
| C | Infectious diseases | Academic detailing | No target area identified. | No target area identified |
aBy chi-square test bBy Interrupted time series analysis (Appendix Table 6)