Appropriate antibiotic prescribing in Community-Acquired Pneumonia in a Norwegian hospital setting
The papers of this thesis are not available in Munin. Paper I. MAT-CAP: a novel medication assessment tool to explore adherence to clinical practice guidelines in community-acquired pneumonia. Høgli JU, Småbrekke L, Garcia BH. Available in Pharmacoepidemiology and Drug Safety 2014; 23: 933–941 Paper...
Main Author: | |
---|---|
Format: | Doctoral or Postdoctoral Thesis |
Language: | English |
Published: |
UiT The Arctic University of Norway
2015
|
Subjects: | |
Online Access: | https://hdl.handle.net/10037/8356 |
id |
ftunivtroemsoe:oai:munin.uit.no:10037/8356 |
---|---|
record_format |
openpolar |
spelling |
ftunivtroemsoe:oai:munin.uit.no:10037/8356 2023-05-15T17:39:25+02:00 Appropriate antibiotic prescribing in Community-Acquired Pneumonia in a Norwegian hospital setting Høgli, June 2015-10-01 https://hdl.handle.net/10037/8356 eng eng UiT The Arctic University of Norway UiT Norges arktiske universitet https://hdl.handle.net/10037/8356 URN:NBN:no-uit_munin_7931 openAccess Copyright 2015 The Author(s) VDP::Medisinske Fag: 700::Helsefag: 800 VDP::Medical disciplines: 700::Health sciences: 800 DOKTOR-003 Doctoral thesis Doktorgradsavhandling 2015 ftunivtroemsoe 2021-06-25T17:54:28Z The papers of this thesis are not available in Munin. Paper I. MAT-CAP: a novel medication assessment tool to explore adherence to clinical practice guidelines in community-acquired pneumonia. Høgli JU, Småbrekke L, Garcia BH. Available in Pharmacoepidemiology and Drug Safety 2014; 23: 933–941 Paper II. Adherence to guideline for empirical antibiotics is safe and reduces risk of readmission of hospitalised patients with community-acquired pneumonia in Norway. Høgli JU, Garcia BH, Svendsen K, Skogen V, Småbrekke L. (Manuscript) Paper III. An audit and feedback intervention study increased appropriate antibiotic prescribing at a Norwegian hospital. Høgli JU, Garcia BH, Skjold F, Skogen V, Småbrekke L. (Manuscript) Appropriate antibiotic prescribing is associated with favourable levels of antimicrobial resistance and clinical outcomes. Literature has indicated that antibiotic treatment of hospitalised patients with community-acquired pneumonia (CAP), the leading cause of death due to infection in adults worldwide, have potential for improvement. The overall aim of this PhD-work has been to promote appropriate antibiotic prescribing in hospitalised patients with CAP. We have developed and validated a Medication Assessment Tool for CAP (MAT-CAP) for retrospective audit of antibiotic prescribing at the University Hospital North Norway (UNN). Consequently, using this tool, areas with low and high quality of prescribing can be identified. Further, we have explored the association between adherence to Norwegian guideline recommendations and mortality, risk of readmission and prolonged length of stay for inpatients with CAP. We identified that adherence to guideline on empirical antibiotic was high, safe and associated with reduced risk of readmission to hospital within 30-days in a selective group of CAP-patients admitted to UNN. Our findings support the Norwegian guideline recommendations, and demonstrate the importance of having guidelines adapted to local and national levels of antimicrobial resistance. Third, in an intervention study we tailored improvement in antibiotic prescribing. The prescribing of appropriate empirical antibiotics increased substantially as a consequence of the intervention, and the effect sustained six months post intervention. However, for reducing total treatment duration and achieving dosage optimization of benzylpenicillin additional prospective interventions are warranted. Doctoral or Postdoctoral Thesis North Norway University of Tromsø: Munin Open Research Archive Høgli ENVELOPE(16.748,16.748,68.507,68.507) Norway Skjold ENVELOPE(19.279,19.279,69.019,69.019) |
institution |
Open Polar |
collection |
University of Tromsø: Munin Open Research Archive |
op_collection_id |
ftunivtroemsoe |
language |
English |
topic |
VDP::Medisinske Fag: 700::Helsefag: 800 VDP::Medical disciplines: 700::Health sciences: 800 DOKTOR-003 |
spellingShingle |
VDP::Medisinske Fag: 700::Helsefag: 800 VDP::Medical disciplines: 700::Health sciences: 800 DOKTOR-003 Høgli, June Appropriate antibiotic prescribing in Community-Acquired Pneumonia in a Norwegian hospital setting |
topic_facet |
VDP::Medisinske Fag: 700::Helsefag: 800 VDP::Medical disciplines: 700::Health sciences: 800 DOKTOR-003 |
description |
The papers of this thesis are not available in Munin. Paper I. MAT-CAP: a novel medication assessment tool to explore adherence to clinical practice guidelines in community-acquired pneumonia. Høgli JU, Småbrekke L, Garcia BH. Available in Pharmacoepidemiology and Drug Safety 2014; 23: 933–941 Paper II. Adherence to guideline for empirical antibiotics is safe and reduces risk of readmission of hospitalised patients with community-acquired pneumonia in Norway. Høgli JU, Garcia BH, Svendsen K, Skogen V, Småbrekke L. (Manuscript) Paper III. An audit and feedback intervention study increased appropriate antibiotic prescribing at a Norwegian hospital. Høgli JU, Garcia BH, Skjold F, Skogen V, Småbrekke L. (Manuscript) Appropriate antibiotic prescribing is associated with favourable levels of antimicrobial resistance and clinical outcomes. Literature has indicated that antibiotic treatment of hospitalised patients with community-acquired pneumonia (CAP), the leading cause of death due to infection in adults worldwide, have potential for improvement. The overall aim of this PhD-work has been to promote appropriate antibiotic prescribing in hospitalised patients with CAP. We have developed and validated a Medication Assessment Tool for CAP (MAT-CAP) for retrospective audit of antibiotic prescribing at the University Hospital North Norway (UNN). Consequently, using this tool, areas with low and high quality of prescribing can be identified. Further, we have explored the association between adherence to Norwegian guideline recommendations and mortality, risk of readmission and prolonged length of stay for inpatients with CAP. We identified that adherence to guideline on empirical antibiotic was high, safe and associated with reduced risk of readmission to hospital within 30-days in a selective group of CAP-patients admitted to UNN. Our findings support the Norwegian guideline recommendations, and demonstrate the importance of having guidelines adapted to local and national levels of antimicrobial resistance. Third, in an intervention study we tailored improvement in antibiotic prescribing. The prescribing of appropriate empirical antibiotics increased substantially as a consequence of the intervention, and the effect sustained six months post intervention. However, for reducing total treatment duration and achieving dosage optimization of benzylpenicillin additional prospective interventions are warranted. |
format |
Doctoral or Postdoctoral Thesis |
author |
Høgli, June |
author_facet |
Høgli, June |
author_sort |
Høgli, June |
title |
Appropriate antibiotic prescribing in Community-Acquired Pneumonia in a Norwegian hospital setting |
title_short |
Appropriate antibiotic prescribing in Community-Acquired Pneumonia in a Norwegian hospital setting |
title_full |
Appropriate antibiotic prescribing in Community-Acquired Pneumonia in a Norwegian hospital setting |
title_fullStr |
Appropriate antibiotic prescribing in Community-Acquired Pneumonia in a Norwegian hospital setting |
title_full_unstemmed |
Appropriate antibiotic prescribing in Community-Acquired Pneumonia in a Norwegian hospital setting |
title_sort |
appropriate antibiotic prescribing in community-acquired pneumonia in a norwegian hospital setting |
publisher |
UiT The Arctic University of Norway |
publishDate |
2015 |
url |
https://hdl.handle.net/10037/8356 |
long_lat |
ENVELOPE(16.748,16.748,68.507,68.507) ENVELOPE(19.279,19.279,69.019,69.019) |
geographic |
Høgli Norway Skjold |
geographic_facet |
Høgli Norway Skjold |
genre |
North Norway |
genre_facet |
North Norway |
op_relation |
https://hdl.handle.net/10037/8356 URN:NBN:no-uit_munin_7931 |
op_rights |
openAccess Copyright 2015 The Author(s) |
_version_ |
1766140187869446144 |