Observational studyBMC emergency medicine2025
Impact of antibiotic post-prescription authorization in resource-limited emergency rooms and acute care units during the COVID-19 pandemic.
Observational study in BMC emergency medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAntimicrobial overuse is a major problem in various healthcare settings, including emergency rooms (ERs) and acute care units (ACUs). This study aimed to evaluate the impact of the post-prescription authorization (PPA) of antibiotics in these settings.
methodsThis retrospective observational study included ER and ACU patients at Siriraj Hospital. In August 2020, a PPA for piperacillin/tazobactam, meropenem, imipenem/cilastatin, and ertapenem was implemented. These antibiotics were unrestricted for the first 72 h; thereafter, infectious disease physician approval was required. Data from pre-implementation (July 2020) and post-implementation (September 2020) periods were compared.
resultsTwo-hundred and six patients were included in the study (103 patients each from the pre- and post-implementation periods). There were no significant differences between the groups regarding male sex (49.5% vs. 47.6%;p = 0.78) and age (67.63 ± 22.9 vs. 66.94 ± 17.4 years;p = 0.27). The respiratory tract was the most common infection site, and piperacillin/tazobactam was the most frequently first-prescribed antibiotic. Using too narrow-spectrum antibiotics was the most common reason for inappropriate antibiotic use. The day of therapy/outpatient-day of the target antibiotics was significantly lower in the post-implementation group (0.85 ± 0.41 vs. 0.72 ± 0.39;p = 0.02). Favorable clinical outcomes were significantly higher in the post-implementation group (42.7% vs. 62.1%;p = 0.005).
conclusionsThis study demonstrates the positive impact of PPA in emergency settings, with a 15% reduction in antibiotic consumption and a 20% increase in favorable clinical outcomes. Future studies should evaluate PPA early in the course of treatment to identify the most effective interventions for improving the quality of care.
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