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:	Jaclyn Bishop, Mark Jones, James Farquharson, Kathrine Summerhayes, Roxanne Tucker, Mary Smith, Raquel Cowan, N. Deborah Friedman, Thomas Schulz, David Kong, Kirsty Buising
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	cellulitis antibiotic stewardship appropriateness rural Therapeutics. Pharmacology RM1-950
Acceso en línea:	https://doaj.org/article/676e06fb12d64a7a9cc90bbc701ecf99
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spelling	oai:doaj.org-article:676e06fb12d64a7a9cc90bbc701ecf992021-11-25T16:22:00ZImplementation of a Cellulitis Management Plan in Three Australian Regional Health Services to Address an Evidence–Practice Gap in Antibiotic Prescribing10.3390/antibiotics101112882079-6382https://doaj.org/article/676e06fb12d64a7a9cc90bbc701ecf992021-10-01T00:00:00Zhttps://www.mdpi.com/2079-6382/10/11/1288https://doaj.org/toc/2079-6382Despite 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.Jaclyn BishopMark JonesJames FarquharsonKathrine SummerhayesRoxanne TuckerMary SmithRaquel CowanN. Deborah FriedmanThomas SchulzDavid KongKirsty BuisingMDPI AGarticlecellulitisantibioticstewardshipappropriatenessruralTherapeutics. PharmacologyRM1-950ENAntibiotics, Vol 10, Iss 1288, p 1288 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	cellulitis antibiotic stewardship appropriateness rural Therapeutics. Pharmacology RM1-950
spellingShingle	cellulitis antibiotic stewardship appropriateness rural Therapeutics. Pharmacology RM1-950 Jaclyn Bishop Mark Jones James Farquharson Kathrine Summerhayes Roxanne Tucker Mary Smith Raquel Cowan N. Deborah Friedman Thomas Schulz David Kong Kirsty Buising Implementation of a Cellulitis Management Plan in Three Australian Regional Health Services to Address an Evidence–Practice Gap in Antibiotic Prescribing
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, <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.
format	article
author	Jaclyn Bishop Mark Jones James Farquharson Kathrine Summerhayes Roxanne Tucker Mary Smith Raquel Cowan N. Deborah Friedman Thomas Schulz David Kong Kirsty Buising
author_facet	Jaclyn Bishop Mark Jones James Farquharson Kathrine Summerhayes Roxanne Tucker Mary Smith Raquel Cowan N. Deborah Friedman Thomas Schulz David Kong Kirsty Buising
author_sort	Jaclyn Bishop
title	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_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_sort	implementation of a cellulitis management plan in three australian regional health services to address an evidence–practice gap in antibiotic prescribing
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/676e06fb12d64a7a9cc90bbc701ecf99
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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

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