Assessing the benefit of the 72-hour antibiotic therapy reassessment documentation

Abstract Objectives To assess the documentation of the 72-hour antibiotic therapy reassessment in medical records. Methods One-day prevalence evaluation of curative antibiotic therapies ≥ 72 hours. The documentation of the reassessment was defined according to three criteria: (1) “clear” documentation (clinical or microbiological comment associated with a comment on the need to adjust the antibiotic therapy or on the lack of need); (2) “tacit” documentation (only based on a clinical or microbiological comment); (3) no documentation. Results We assessed 114 antibiotic therapies in 26 hospital departments. A clear reassessment at 72 hours was observed in only 45 (39%) records and 31 (27%) records had no reassessment. The planned duration of treatment was written in 63 (55%) records. At 72 hours, among the 71 antibiotic therapies with a microbiological documentation, 69 (97%) were active and 44 (62%) had a narrow spectrum. Among the 48 antibiotic therapies with a broad spectrum on day 1, only 21 (44%) benefited from a de-escalation at 72 hours. A clearly recorded reassessment at 72 hours was associated with de-escalation ( P  = 0.025) and the prescription of a planned duration of treatment was associated with antibiotic therapy compliance with local or national guidelines ( P  = 0.018). Conclusion Although reassessment was observed in 73% of records, it was correctly recorded at 72 hours in only 39% of cases. The documentation of the reassessment and the prescription of a planned duration were associated with a better quality of antibiotic prescription (de-escalation, compliance with guidelines) and are relevant indicators for monitoring the proper use of antibiotics.