Surveillance of Emergency Department Antimicrobial Stewardship Practices in Sherwood Park, Alberta, Canada: A Closer Look at Respiratory Tract Infection Prescribing Patterns in Primary Care
Bibliographic record
Abstract
Background. Concerns exist regarding antimicrobial prescribing for respiratory tract infections (RTIs) due to adverse reactions, avoidable drug costs, and the development of antimicrobial resistance. In RTI specifically, inappropriate antibiotic treatment of viral infections and guideline-concordant treatment of RTI remain areas of concern. The purpose of this investigation was to inform administration, prescribers, pharmacists and other allied health workers on the current state of antimicrobial prescribing surrounding RTI, and to measure the impact of regular reporting on patient outcomes and appropriate antimicrobial prescribing. Methods. A retrospective examination of adult patients who presented to the Strathcona Community Hospital emergency department (Sherwood Park, Alberta, Canada) between July and October 2015 with RTI symptoms (e.g. cough, sore throat, dyspnea). The primary outcome was treatment concordance to existing national and local practice guidelines (e.g. CHEST, Bugs and Drugs, Towards Optimized Practice). Secondary measures included reason(s) for non-concordance, diagnostics measured, and classes and volume of antimicrobials prescribed. Results. A total of 282 charts were reviewed, 142 of which were included in the analysis; 91 (64%) were female and the median age was 37 years (range 18–97 years). Overall concordance to guidelines was 86%, driven by appropriate viral illness treatment (symptomatic relief only). Twenty admissions (14%) resulted in an antimicrobial being dispensed, of which only 3 (15%) were concordant with guidelines. The most popular antimicrobials prescribed were azithromycin (30%) and amoxicillin (20%). Conclusion. There is sufficient practice of providing only symptomatic relief for viral RTI; however, there still exists a gap between ideal use of antimicrobials in respiratory infection and current practice. Disclosures. All authors: No reported disclosures
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.004 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".