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Implementation of a Cellulitis Management Plan in Three Australian Regional Health Services to Address an Evidence–Practice Gap in Antibiotic Prescribing

Despite the availability of evidence-based guidelines, antibiotics for cellulitis remain inappropriately prescribed. This evidence–practice gap is more evident in low-resource settings, such as rural hospitals. This implementation study developed and introduced a cellulitis management plan to improv...

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Autores principales: Bishop, Jaclyn, Jones, Mark, Farquharson, James, Summerhayes, Kathrine, Tucker, Roxanne, Smith, Mary, Cowan, Raquel, Friedman, N. Deborah, Schulz, Thomas, Kong, David, Buising, Kirsty
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8615114/
https://www.ncbi.nlm.nih.gov/pubmed/34827226
http://dx.doi.org/10.3390/antibiotics10111288
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author Bishop, Jaclyn
Jones, Mark
Farquharson, James
Summerhayes, Kathrine
Tucker, Roxanne
Smith, Mary
Cowan, Raquel
Friedman, N. Deborah
Schulz, Thomas
Kong, David
Buising, Kirsty
author_facet Bishop, Jaclyn
Jones, Mark
Farquharson, James
Summerhayes, Kathrine
Tucker, Roxanne
Smith, Mary
Cowan, Raquel
Friedman, N. Deborah
Schulz, Thomas
Kong, David
Buising, Kirsty
author_sort Bishop, Jaclyn
collection PubMed
description Despite the availability of evidence-based guidelines, antibiotics for cellulitis remain inappropriately prescribed. This evidence–practice gap is more evident in low-resource settings, such as rural hospitals. This implementation study developed and introduced a cellulitis management plan to improve antibiotic prescribing for cellulitis in three health services in regional Australia. Appropriateness of antibiotic prescribing for cellulitis at Day 1 was the primary outcome measure. Adults with ICD-10-AM codes for lower-limb cellulitis admitted as inpatients of the three health services between May and November 2019 (baseline, n = 165) and March and October 2020 (post-implementation, n = 127) were included in the assessment. The uptake of the cellulitis management plan was 29.1% (37/127). The appropriateness of antibiotic prescribing for cellulitis at Day 1 was similar at baseline (78.7%, 144/183) and in the intention-to-treat post-implementation group (81.8%, 126/154) [95% CI −5.6% to 11.3%, p = 0.50]. Commencement of the cellulitis management plan resulted in a non-statistically significant increase in antibiotic appropriateness at Day 1 compared to when a cellulitis management plan was not commenced (88.1% vs. 79.5%; 95% CI −5.6% to 19.8%; p = 0.20) Evaluation of more real-world strategies to address evidence–practice gaps, such as the appropriateness of antibiotic prescribing for cellulitis, is required.
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spelling pubmed-86151142021-11-26 Implementation of a Cellulitis Management Plan in Three Australian Regional Health Services to Address an Evidence–Practice Gap in Antibiotic Prescribing Bishop, Jaclyn Jones, Mark Farquharson, James Summerhayes, Kathrine Tucker, Roxanne Smith, Mary Cowan, Raquel Friedman, N. Deborah Schulz, Thomas Kong, David Buising, Kirsty Antibiotics (Basel) Article Despite the availability of evidence-based guidelines, antibiotics for cellulitis remain inappropriately prescribed. This evidence–practice gap is more evident in low-resource settings, such as rural hospitals. This implementation study developed and introduced a cellulitis management plan to improve antibiotic prescribing for cellulitis in three health services in regional Australia. Appropriateness of antibiotic prescribing for cellulitis at Day 1 was the primary outcome measure. Adults with ICD-10-AM codes for lower-limb cellulitis admitted as inpatients of the three health services between May and November 2019 (baseline, n = 165) and March and October 2020 (post-implementation, n = 127) were included in the assessment. The uptake of the cellulitis management plan was 29.1% (37/127). The appropriateness of antibiotic prescribing for cellulitis at Day 1 was similar at baseline (78.7%, 144/183) and in the intention-to-treat post-implementation group (81.8%, 126/154) [95% CI −5.6% to 11.3%, p = 0.50]. Commencement of the cellulitis management plan resulted in a non-statistically significant increase in antibiotic appropriateness at Day 1 compared to when a cellulitis management plan was not commenced (88.1% vs. 79.5%; 95% CI −5.6% to 19.8%; p = 0.20) Evaluation of more real-world strategies to address evidence–practice gaps, such as the appropriateness of antibiotic prescribing for cellulitis, is required. MDPI 2021-10-22 /pmc/articles/PMC8615114/ /pubmed/34827226 http://dx.doi.org/10.3390/antibiotics10111288 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Bishop, Jaclyn
Jones, Mark
Farquharson, James
Summerhayes, Kathrine
Tucker, Roxanne
Smith, Mary
Cowan, Raquel
Friedman, N. Deborah
Schulz, Thomas
Kong, David
Buising, Kirsty
Implementation of a Cellulitis Management Plan in Three Australian Regional Health Services to Address an Evidence–Practice Gap in Antibiotic Prescribing
title Implementation of a Cellulitis Management Plan in Three Australian Regional Health Services to Address an Evidence–Practice Gap in Antibiotic Prescribing
title_full Implementation of a Cellulitis Management Plan in Three Australian Regional Health Services to Address an Evidence–Practice Gap in Antibiotic Prescribing
title_fullStr Implementation of a Cellulitis Management Plan in Three Australian Regional Health Services to Address an Evidence–Practice Gap in Antibiotic Prescribing
title_full_unstemmed Implementation of a Cellulitis Management Plan in Three Australian Regional Health Services to Address an Evidence–Practice Gap in Antibiotic Prescribing
title_short Implementation of a Cellulitis Management Plan in Three Australian Regional Health Services to Address an Evidence–Practice Gap in Antibiotic Prescribing
title_sort implementation of a cellulitis management plan in three australian regional health services to address an evidence–practice gap in antibiotic prescribing
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8615114/
https://www.ncbi.nlm.nih.gov/pubmed/34827226
http://dx.doi.org/10.3390/antibiotics10111288
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