Universität zu Köln

Vehreschild, J. J., Morgen, G., Cornely, O. A., Hartmann, P., Koch, S., Kalka-Moll, W., Wyen, C., Vehreschild, M. J. G. T., Lehmann, C., Gillor, D., Seifert, H., Kremer, G., Faetkenheuer, G. and Jung, N. (2013). Evaluation of an infectious disease consultation programme in a German tertiary care hospital. Infection, 41 (6). S. 1121 - 1129. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1439-0973

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Abstract

To evaluate a newly implemented infectious disease (ID) consultation service in terms of patient care, outcome and antibiotic prescription and to describe factors influencing adherence to recommendations. Data from consultations during the first 6 months of the ID consultation program were collected and evaluated. Consultation requests, diagnostic results, treatment outcomes and antibiotic recommendations were categorised. Diagnostic and therapeutic recommendations were assessed and rated for adherence and outcome. Statistical analysis was performed to identify factors influencing adherence and treatment outcome. A total of 251 consultations were assessed. In most cases, ID specialists were asked for further advice regarding a previously initiated anti-infective treatment (N = 131, 52 %). In 54 of 195 (28 %) first consultations, the ID specialist proposed a differential diagnosis that differed from that of the working diagnoses submitted with the consultation request, and which was subsequently confirmed in 80 % of these cases. Diagnostic and therapeutic recommendations were made in 190 (76 %) and 240 (96 %) of the consultations, respectively. A change in the current treatment was recommended in 66 % of consultations; 37 % of recommendations were cost-saving and 26 % were cost-neutral. Compliance with diagnostic and therapeutic recommendations was rated as good by pre-specified criteria in 65 and 86 % of consultations, respectively. Treatment outcome was correlated with adherence to diagnostic recommendations (P = 0.012). Twenty-nine patients (16 %) died during the same hospital stay. Infectious disease consultations may help to establish the correct diagnosis, resulting in the appropriate treatment being provided to a severely sick patient population. Treatment outcome was improved in cases of good diagnostic adherence to the recommendations of the ID specialist.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Vehreschild, J. J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Morgen, G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Cornely, O. A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hartmann, P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Koch, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kalka-Moll, W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wyen, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Vehreschild, M. J. G. T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Lehmann, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Gillor, D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Seifert, H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kremer, G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Faetkenheuer, G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Jung, N. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-471176
DOI:	10.1007/s15010-013-0512-1
Journal or Publication Title:	Infection
Volume:	41
Number:	6
Page Range:	S. 1121 - 1129
Date:	2013
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1439-0973
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language STAPHYLOCOCCUS-AUREUS; ANTIBIOTIC USE; RECOMMENDATIONS; ADHERENCE; APPROPRIATENESS; SPECIALISTS; PREVALENCE; MANAGEMENT; RESISTANCE; OUTCOMES Multiple languages Infectious Diseases Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/47117