Antibiotic Stewardship Audit in Gerontology wards in Princess Royal University Hospital

Title: Antibiotic Stewardship Audit in Gerontology wards in Princess Royal University Hospital 

Introduction: Misuse of antibiotics leads to the emergence of antimicrobial resistance, which is an important public health and patient safety issue. Infections caused by resistant organisms are associated with poorer clinical outcomes and undesired side effects.

Aim: Assessing compliance with the antimicrobial stewardship package introduced by the UK Department of Health in 2011 and with the trust guidelines.  

Method:

* Spot checks done across all gerontology wards between January and March 2024 to assess the compliance as described above.

* Intervention: Teaching sessions for junior doctors discussing the first cycle’s results, the main lacking areas, and the takeaway messages.

* Second spot checks in May and June. The results were presented in the Adult Medicine Conference at the trust.

Results:

* Improvement in documenting clinical indications to an average of 90%.

* Compliance with local antibiotic guidelines improved to an average of 80%

* Documentation of a reason for continuing IV antibiotics after 48 hours and factors preventing a per-oral switch improved to an average of 80%.

* Areas of improvement identified in documenting CURB65 score for community acquired pneumonia

Conclusion: The audit and the interventions showed marked improvement in antibiotic prescriptions and compliance with the trust guidelines. Despite being a common basic audit, it encourages junior doctors to check the trust policy and prescribe accordingly. This is important in the geriatric population who are at increased risk of side effects due to co- morbidities and drug interactions because of polypharmacy.