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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| Main Authors: | , , , , , , , , , , |
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| Format: | Book |
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MDPI AG,
2021-10-01T00:00:00Z.
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| Summary: | 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, <i>n</i> = 165) and March and October 2020 (post-implementation, <i>n</i> = 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%, <i>p</i> = 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%; <i>p</i> = 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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| Item Description: | 10.3390/antibiotics10111288 2079-6382 |