Prevalence and management of antibiotic associated XXXX in general hospitals.

@entity1 @entity294 @entity2718
BACKGROUND: Antibiotic-associated @entity294 (AAD) is a common adverse effect of antibiotic (AB) treatment. This study aimed to measure the overall prevalence of AAD (including mild to moderate @entity294 ) in hospitalized AB treated @entity1 , to investigate associated risk factors and to document AAD associated diagnostic investigations, contamination control and treatment. METHODS: During 8 observation days (with time delay of 10-14 days between each observation day), all adult @entity1 hospitalized at an internal medicine ward of 4 Belgian participating hospitals were screened for AB use. @entity1 receiving AB on the observation day were included in the study and screened for signs and symptoms of AAD using a period prevalence methodology. Clinical data were collected for all AB users and AAD related investigations and treatment were collected for the entire duration of AAD. Additionally, nurses noted daily the frequency of all extra care associated to the treatment of the @entity294 . RESULTS: A total of 2543 hospitalized @entity1 were screened of which 743 were treated with AB (29.2%). Included AB users had a mean age of 68 yr (range 16-99) and 52% were male. Penicillins were mostly used (63%) and 19% received more than one AB. AAD was observed in 9.6% of AB users including 4 with confirmed @entity2718 infection. AAD started between 1 and 16 days after AB start (median 5) and had a duration of 2 to 41 days (median 4). AAD was significantly associated with higher age and the use of double AB and proton pump inhibitors. AAD @entity1 had extra laboratory investigations (79%), received extra pharmacological treatment (42%) and 10 of them were isolated (14%). AAD related extra nursing time amounted to 51 minutes per day for the treatment of @entity294 . CONCLUSIONS: In this observational study, with one third of hospitalized @entity1 receiving AB, an AAD period prevalence of 9.6% in AB users was found. AAD caused extra investigations and treatment and an estimated extra nursing care of almost one hour per day. Preventive action are highly recommended to reduce the prevalence of AAD and associated health care costs.
