PT  - JOURNAL ARTICLE
AU  - Rebecca Dickinson
AU  - Jamie Talbot
AU  - Joanne Thompson
AU  - Helena Cummings
AU  - Jaymin Morjaria
TI  - Does having previous sputum results improve rationalisation of antimicrobial prescribing during acute exacerbations of COPD?
DP  - 2014 Sep 01
TA  - European Respiratory Journal
PG  - P2580
VI  - 44
IP  - Suppl 58
4099  - http://erj.ersjournals.com/content/44/Suppl_58/P2580.short
4100  - http://erj.ersjournals.com/content/44/Suppl_58/P2580.full
SO  - Eur Respir J2014 Sep 01; 44
AB  - BackgroundPatients presenting with acute exacerbations of COPD (AECOPD) are regularly prescribed antibiotic therapy. Previous sputum microbiological cultures are a useful guide to tailoring antibiotic therapy. To reduce antibiotic resistance there is a push towards using narrow spectrum antibiotic therapy (AT). We examined whether local antibiotic prescribing was in concordance with known sputum microbiology or guidelines.MethodsWe reviewed two months of AECOPD admissions to our tertiary hospital. Previous sputum microbiology (4 weeks to 5 years) and index admission AT data was collected. Appropriate AT was defined as narrow spectrum antibiotics given according to previous sputum culture or according to hospital guidelines for AECOPD if no previous or a previous negative sputum or pneumonia if diagnosed.Results117 patients with a mean ages of 72.5 years (58M: 59F), out of 159 admissions, were reviewed. Table 1 summaries AT and concordance with previous sputum microbiology.View this table:Sixteen (53%) patients with no previous sputum results were given broad spectrum antibiotics.ConclusionMany patients were inappropriately prescribed broad spectrum antibiotics without consideration of previous sputum microbiology or hospital guidelines. Education of medical staff is extremely important to improve concordance and reduce inappropriate AT.