Avoiding Improper Antibiotic Use Means Relying on More Than Intuition
(HealthDay News) — Misdiagnosis often leads to improper antibiotic use in hospitals, according to a study published online May 18 in Infection Control & Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America.
"Antibiotic therapies are used for approximately 56 percent of inpatients in U.S. hospitals, but are found to be inappropriate in nearly half of these cases, and many of these failures are connected with inaccurate diagnoses," study author Greg Filice, M.D., of the Minneapolis Veterans Affairs Health Care System, said in a news release from the Society for Healthcare Epidemiology of America.
Filice and colleagues analyzed 500 inpatient cases at the Minneapolis VA Medical Center. They found that inappropriate use of antibiotics occurred with 95 percent of patients who received an incorrect or indeterminate diagnosis, or those with an identified symptom but no diagnosis. By comparison, incorrect use of antibiotics occurred in 38 percent of patients who received a correct diagnosis. Overall, only 58 percent of patients received a correct diagnosis, the researchers found. The most common misdiagnoses were pneumonia, cystitis, urinary tract infections, kidney infections, and urosepsis.
According to the researchers, relying on intuition rather than proper analysis contributed to incorrect diagnoses and inappropriate use of antibiotics at hospitals. Other contributing factors on the part of staff were fatigue, sleep deprivation, mental overload, dealing with patients with a previous diagnosis from another health care provider, lack of clinical experience, and lack of experience with drug side effects. "Diagnostic accuracy is integral to the safe use of antibiotics. In order to improve the use of antibiotics in health care, we must consider this challenge and look for tools and strategies that help clinicians decrease unnecessary and potentially harmful antibiotic use" Filice said.