Impact of the inpatient infectious disease consultations at a tertiary care university hospital

Authors

  • Rami Waked Universite saint Joseph
  • Danielle Jaafar Departement of Infectious Disease, Villeneuve-Saint-Georges, Paris, France
  • Marie Chedid Department of Infectious Diseases, Saint Joseph University, Beirut, Lebanon
  • Gebrael Saliba Department of Infectious Diseases, Saint Joseph University, Beirut, Lebanon
  • Elie Haddad Department of Infectious Diseases, Saint Joseph University, Beirut, Lebanon
  • Jacques Choucair Department of Infectious Diseases, Saint Joseph University, Beirut, Lebanon

DOI:

https://doi.org/10.3823/844

Keywords:

Infectious Disease specialist, Consultation services, Antibiotic stewardship, Antibiotic de-escalation, Impact Assessment, Inpatient treatment

Abstract

BACKGROUND: The role of the infectious disease specialist continues to evolve. The purpose of this study is to demonstrate the value of infectious disease consultation in the inpatient setting.

METHODS: This is a prospective cohort study that took place in a tertiary care university hospital. During the period from April to June 2016, 224 cases of patients receiving antibiotics in the hospital with the request of an infectious diseases’ consultation, were evaluated. The following variables were assessed: the referring department, purpose of the consultation, the antibiotic used before requesting the infectious diseases consultation, the antibiotic modifications after the infectious disease’s visit, whenever the antibiotic usage was switched to a mono or bi-therapy.

RESULTS: The most frequent requesting departments were Oncology (23.2%) and Urology (21.4%). The purpose of the consultations was diagnosis (29%), therapy (41%), both diagnosis and therapy (21%), and prophylaxis (9%). An infectious diseases consultation was given at a rate of 4.9 consultations per 100 hospitalized patients. Antibiotic was discontinued in 14.7% of cases. There was no indication for the antibiotic treatment in 11.6% of cases. Modifying the antibiotic therapy was done in 25.4% of cases. Adjusting the antibiotic dosage was done in only one case. Carbapenem antibiotics were discontinued in 31.6 % of cases and Quinolones discontinuation accounted for 22.7% of cases.

CONCLUSION: Infectious disease consults contributed to the optimization of the diagnostic and therapeutic approaches for suspected or confirmed infections in hospitalized patients.

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2020-07-05

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