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JAC Advance Access published online on June 26, 2007
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkm233
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© The Author 2007. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Appropriateness of antibiotic therapy on weekends versus weekdays

Jihad Bishara1,2,*, Dov Hershkovitz2,3, Mical Paul1,2, Zvi Rotenberg2,4 and Silvio Pitlik1,2,3

1 Infectious Diseases Unit, Rabin Medical Center, Beilinson Hospital, Petah-Tiqwa 49100, Israel 2 Sackler School of Medicine, Tel Aviv University, Tel-Aviv, Israel 3 Department of Internal Medicine C, Rabin Medical Center, Beilinson Hospital, Petah-Tiqwa, Israel 4 Department of Emergency Medicine, Rabin Medical Center, Beilinson Hospital, Petah-Tiqwa, Israel

Received 18 April 2007; returned 14 May 2007; revised 19 May 2007; accepted 5 June 2007

* Corresponding author. Tel: +972-3-937-7511; Fax: +972-3-937-7513; E-mail: jihadb{at}clalit.org.il or bishara{at}netvision.net.il

Objectives: To compare the appropriateness of antibiotic treatment prescribed in an emergency department (ED) of a tertiary medical centre on weekdays and weekends.

Methods: During a 1 month period, medical charts of 1029 ED visits for patients who were discharged from the ED were reviewed. Data of patients who were discharged with antibiotics were blind evaluated by two infectious disease specialists, and an ‘appropriateness score’ was given to the antibiotic prescription.

Results: Antibiotics were prescribed at discharge for 182 (17.7%) patients. Appropriate antibiotic treatment was administered significantly less frequently on weekends when compared with weekdays (P = 0.004). Appropriateness scores were higher for the surgical and urological wings (P = 0.011) and for diagnoses of pneumonia and urinary tract infection (P = 0.005). Time of the day and patient's age and sex did not have a significant effect on the appropriateness score. Adjusting for all variables, only weekends remained significantly associated with less appropriate antibiotic treatment, odds ratio 0.35 and 95% confidence intervals 0.16–0.78.

Conclusions: This study shows less appropriate antibiotic prescription in an ED on weekends than weekdays. More studies are required to clarify measures to improve appropriate antibiotic therapy at weekends.

Key Words: antibiotic prescriptions , weekly variation , prescribing


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