Antibiotic usage in community-acquired infections in hospitals in Taiwan

Monto Ho, Feng Yee Chang, Hsiao Chuan Yin, Ren Jy Ben, Luan Yin Chang, Po Yen Chen, Shu Hsing Cheng, Shu Ting Chen, Fang Liang Huang, Hsiu Chen Lin, Daniel C T Lu, Ning Chi Wang, Jann Tay Wang

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background and Purpose: Using an epidemiologically meaningful in-hospital population with community-acquired infections, we evaluated antibiotic therapy in terms of indication and choice of antibiotic and microbiologic work-up. Methods: Infectious disease specialists evaluated charts of 436 patients from 9 hospitals and selected those who received antibiotics within 3 days of admission. Each antibiotic prescribed was marked for appropriateness of indication and choice. Microbiologic isolates were evaluated for their clinical significance. Results: The most common infections were in the lower respiratory tract (46.1%). Each patient received a mean of 2.25 antibiotics for 8.1 ± 6.4 days. Of the 975 courses of antibiotics given in the study period, indication and choice were correct in 37.4% and unsatisfactory in 14.5%. The vast majority of antibiotics used (79.2%) were first-line antibiotics - usually first-generation cephalosporins, aminoglycosides, and aminopenicillins. Most patients (66%) had a microbiology laboratory work-up, but only 37.4% were judged by evaluators to have a meaningful microbiologic diagnosis. Among the 201 patients with lower respiratory tract infections, 105 (52.2%) had a diagnosis of pneumonia. A positive isolate was recovered in 30 (28.6%) patients, and most of these isolates (20,68.7%) were aerobic gram-negative rods. There were three positive blood cultures but none grew Streptococcus pneumoniae. Conclusions: Antibiotics were used excessively in number and duration. The microbiologic work-up had little effect on the indication and choice of antibiotics. Community-acquired pneumonia differed markedly from that in Western countries in that only 3.3% were caused by S. pneumoniae.

Original languageEnglish
Pages (from-to)34-42
Number of pages9
JournalJournal of the Formosan Medical Association
Volume101
Issue number1
Publication statusPublished - 2002
Externally publishedYes

Fingerprint

Community-Acquired Infections
Taiwan
Anti-Bacterial Agents
Streptococcus pneumoniae
Pneumonia
Aminoglycosides
Cephalosporins
Microbiology
Respiratory Tract Infections
Respiratory System
Communicable Diseases

Keywords

  • Appropriate antibiotics
  • In-hospital infections
  • Pneumonias

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Ho, M., Chang, F. Y., Yin, H. C., Ben, R. J., Chang, L. Y., Chen, P. Y., ... Wang, J. T. (2002). Antibiotic usage in community-acquired infections in hospitals in Taiwan. Journal of the Formosan Medical Association, 101(1), 34-42.

Antibiotic usage in community-acquired infections in hospitals in Taiwan. / Ho, Monto; Chang, Feng Yee; Yin, Hsiao Chuan; Ben, Ren Jy; Chang, Luan Yin; Chen, Po Yen; Cheng, Shu Hsing; Chen, Shu Ting; Huang, Fang Liang; Lin, Hsiu Chen; Lu, Daniel C T; Wang, Ning Chi; Wang, Jann Tay.

In: Journal of the Formosan Medical Association, Vol. 101, No. 1, 2002, p. 34-42.

Research output: Contribution to journalArticle

Ho, M, Chang, FY, Yin, HC, Ben, RJ, Chang, LY, Chen, PY, Cheng, SH, Chen, ST, Huang, FL, Lin, HC, Lu, DCT, Wang, NC & Wang, JT 2002, 'Antibiotic usage in community-acquired infections in hospitals in Taiwan', Journal of the Formosan Medical Association, vol. 101, no. 1, pp. 34-42.
Ho M, Chang FY, Yin HC, Ben RJ, Chang LY, Chen PY et al. Antibiotic usage in community-acquired infections in hospitals in Taiwan. Journal of the Formosan Medical Association. 2002;101(1):34-42.
Ho, Monto ; Chang, Feng Yee ; Yin, Hsiao Chuan ; Ben, Ren Jy ; Chang, Luan Yin ; Chen, Po Yen ; Cheng, Shu Hsing ; Chen, Shu Ting ; Huang, Fang Liang ; Lin, Hsiu Chen ; Lu, Daniel C T ; Wang, Ning Chi ; Wang, Jann Tay. / Antibiotic usage in community-acquired infections in hospitals in Taiwan. In: Journal of the Formosan Medical Association. 2002 ; Vol. 101, No. 1. pp. 34-42.
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abstract = "Background and Purpose: Using an epidemiologically meaningful in-hospital population with community-acquired infections, we evaluated antibiotic therapy in terms of indication and choice of antibiotic and microbiologic work-up. Methods: Infectious disease specialists evaluated charts of 436 patients from 9 hospitals and selected those who received antibiotics within 3 days of admission. Each antibiotic prescribed was marked for appropriateness of indication and choice. Microbiologic isolates were evaluated for their clinical significance. Results: The most common infections were in the lower respiratory tract (46.1{\%}). Each patient received a mean of 2.25 antibiotics for 8.1 ± 6.4 days. Of the 975 courses of antibiotics given in the study period, indication and choice were correct in 37.4{\%} and unsatisfactory in 14.5{\%}. The vast majority of antibiotics used (79.2{\%}) were first-line antibiotics - usually first-generation cephalosporins, aminoglycosides, and aminopenicillins. Most patients (66{\%}) had a microbiology laboratory work-up, but only 37.4{\%} were judged by evaluators to have a meaningful microbiologic diagnosis. Among the 201 patients with lower respiratory tract infections, 105 (52.2{\%}) had a diagnosis of pneumonia. A positive isolate was recovered in 30 (28.6{\%}) patients, and most of these isolates (20,68.7{\%}) were aerobic gram-negative rods. There were three positive blood cultures but none grew Streptococcus pneumoniae. Conclusions: Antibiotics were used excessively in number and duration. The microbiologic work-up had little effect on the indication and choice of antibiotics. Community-acquired pneumonia differed markedly from that in Western countries in that only 3.3{\%} were caused by S. pneumoniae.",
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T1 - Antibiotic usage in community-acquired infections in hospitals in Taiwan

AU - Ho, Monto

AU - Chang, Feng Yee

AU - Yin, Hsiao Chuan

AU - Ben, Ren Jy

AU - Chang, Luan Yin

AU - Chen, Po Yen

AU - Cheng, Shu Hsing

AU - Chen, Shu Ting

AU - Huang, Fang Liang

AU - Lin, Hsiu Chen

AU - Lu, Daniel C T

AU - Wang, Ning Chi

AU - Wang, Jann Tay

PY - 2002

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N2 - Background and Purpose: Using an epidemiologically meaningful in-hospital population with community-acquired infections, we evaluated antibiotic therapy in terms of indication and choice of antibiotic and microbiologic work-up. Methods: Infectious disease specialists evaluated charts of 436 patients from 9 hospitals and selected those who received antibiotics within 3 days of admission. Each antibiotic prescribed was marked for appropriateness of indication and choice. Microbiologic isolates were evaluated for their clinical significance. Results: The most common infections were in the lower respiratory tract (46.1%). Each patient received a mean of 2.25 antibiotics for 8.1 ± 6.4 days. Of the 975 courses of antibiotics given in the study period, indication and choice were correct in 37.4% and unsatisfactory in 14.5%. The vast majority of antibiotics used (79.2%) were first-line antibiotics - usually first-generation cephalosporins, aminoglycosides, and aminopenicillins. Most patients (66%) had a microbiology laboratory work-up, but only 37.4% were judged by evaluators to have a meaningful microbiologic diagnosis. Among the 201 patients with lower respiratory tract infections, 105 (52.2%) had a diagnosis of pneumonia. A positive isolate was recovered in 30 (28.6%) patients, and most of these isolates (20,68.7%) were aerobic gram-negative rods. There were three positive blood cultures but none grew Streptococcus pneumoniae. Conclusions: Antibiotics were used excessively in number and duration. The microbiologic work-up had little effect on the indication and choice of antibiotics. Community-acquired pneumonia differed markedly from that in Western countries in that only 3.3% were caused by S. pneumoniae.

AB - Background and Purpose: Using an epidemiologically meaningful in-hospital population with community-acquired infections, we evaluated antibiotic therapy in terms of indication and choice of antibiotic and microbiologic work-up. Methods: Infectious disease specialists evaluated charts of 436 patients from 9 hospitals and selected those who received antibiotics within 3 days of admission. Each antibiotic prescribed was marked for appropriateness of indication and choice. Microbiologic isolates were evaluated for their clinical significance. Results: The most common infections were in the lower respiratory tract (46.1%). Each patient received a mean of 2.25 antibiotics for 8.1 ± 6.4 days. Of the 975 courses of antibiotics given in the study period, indication and choice were correct in 37.4% and unsatisfactory in 14.5%. The vast majority of antibiotics used (79.2%) were first-line antibiotics - usually first-generation cephalosporins, aminoglycosides, and aminopenicillins. Most patients (66%) had a microbiology laboratory work-up, but only 37.4% were judged by evaluators to have a meaningful microbiologic diagnosis. Among the 201 patients with lower respiratory tract infections, 105 (52.2%) had a diagnosis of pneumonia. A positive isolate was recovered in 30 (28.6%) patients, and most of these isolates (20,68.7%) were aerobic gram-negative rods. There were three positive blood cultures but none grew Streptococcus pneumoniae. Conclusions: Antibiotics were used excessively in number and duration. The microbiologic work-up had little effect on the indication and choice of antibiotics. Community-acquired pneumonia differed markedly from that in Western countries in that only 3.3% were caused by S. pneumoniae.

KW - Appropriate antibiotics

KW - In-hospital infections

KW - Pneumonias

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