TY - JOUR
T1 - Effect of Hospitalwide Change in Clindamycin Closing Schedule on Clinical Outcome
AU - Buchwald, Dedra
AU - Soumerai, Stephen B.
AU - Vandevanter, Nancy
AU - Wessels, Michael R.
AU - Avorn, Jerry
N1 - Funding Information:
Received for publication 6 July 1987 and in revised form 1 November 1988. The authors thank William Taylor, Jerome Janousek, and Malcolm Weiner (Beth Israel Hospital) for their participation in the establishment of the antibiotic ordering systemand Sharon Hawley and Susanne Bellavance (Harvard Medical School) for data analysis and preparation of the manuscript. Research for this paper was funded by the Beth Israel Hospital (Boston) Program for the Analysis of Clinical Strategies and by the Fund for Cooperative Innovation of Blue Cross of Massachusetts. ·Current affiliation: Division of General Medicine, University of Washington, Harborview Medical Center, Seattle, Washington. Please address requests for reprints to Dr. Stephen Soumerai, Program for the Analysis of Clinical Strategies, 333 Longwood Avenue, Boston, Massachusetts 02115.
PY - 1989/7
Y1 - 1989/7
N2 - We compared clinical outcomes of 65 hospitalized patients receiving clindamycin before and 59 after a sudden hospital wide shift in dosing schedules for this drug from 600 mg every 6 hours to 600 mg every 8 hours. Outcomes studied included the efficacy of antibiotic treatment, length of febrile period, and frequency of adverse effects. We also compared and controlled for patient characteristics such as age, sex, presence of multiple diagnoses, length of therapy, and concurrent use of other antibiotics. There were no differences in measured clinical outcomes between the two groups. Treatment was successful in 87% of both groups. The average number of febrile days was 5.1 in the first group and 3.9 in the second (P<.05). Patients on 6-hourly therapy experienced a 12% rate of antibioticrelated adverse effects vs. 5% for the 8-hourly group (P<.05). These data support the clinical rationale and safety of a hospitalwide reduction in the frequency of clindamycin dosing. In addition to considerable pharmacy and nursing time saved, this change also saved$40,000 annually in antibiotic costs.
AB - We compared clinical outcomes of 65 hospitalized patients receiving clindamycin before and 59 after a sudden hospital wide shift in dosing schedules for this drug from 600 mg every 6 hours to 600 mg every 8 hours. Outcomes studied included the efficacy of antibiotic treatment, length of febrile period, and frequency of adverse effects. We also compared and controlled for patient characteristics such as age, sex, presence of multiple diagnoses, length of therapy, and concurrent use of other antibiotics. There were no differences in measured clinical outcomes between the two groups. Treatment was successful in 87% of both groups. The average number of febrile days was 5.1 in the first group and 3.9 in the second (P<.05). Patients on 6-hourly therapy experienced a 12% rate of antibioticrelated adverse effects vs. 5% for the 8-hourly group (P<.05). These data support the clinical rationale and safety of a hospitalwide reduction in the frequency of clindamycin dosing. In addition to considerable pharmacy and nursing time saved, this change also saved$40,000 annually in antibiotic costs.
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U2 - 10.1093/clinids/11.4.619
DO - 10.1093/clinids/11.4.619
M3 - Article
C2 - 2772467
AN - SCOPUS:0024697870
SN - 1058-4838
VL - 11
SP - 619
EP - 624
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - 4
ER -