Article ; Online: Management of acute diarrhea in the emergency department of a tertiary care university medical center.
The Journal of international medical research
2022 Volume 50, Issue 8, Page(s) 3000605221115385
Abstract: Objectives: To examine the management of acute diarrhea in the emergency department (ED) of a large university medical center.: Methods: Retrospective cross-sectional study over a 10-month period of adult patients (age ≥18 years) presenting to the ED ...
| Abstract | Objectives: To examine the management of acute diarrhea in the emergency department (ED) of a large university medical center. Methods: Retrospective cross-sectional study over a 10-month period of adult patients (age ≥18 years) presenting to the ED with acute diarrhea. Results: Data for 780 patients were reviewed; 101 met the exclusion criteria. Of the 679 patients with acute community-acquired diarrhea, 582 (85.7%) were discharged home and constituted the study cohort of mostly healthy adults (mean age: 32.5 ± 14.5 years). The rate of antibiotic prescription at discharge was 26%. Inappropriate use of antibiotics occurred in 28% of the patients. The presence of fever (odds ratio (OR) = 3.52), leukocytosis (OR = 1.72), and older age (OR = 1.16) were predictors of antibiotic prescription. Patients with dehydration, comorbidities, or bloody diarrhea were more likely to receive antibiotics. Microbiological studies and cross-sectional imaging were ordered in 12.4% and 11.7% of the patients, respectively, but provided very low yield (<10% for both) resulting in significantly higher visit charges. Inappropriately prescribed antibiotics at discharge resulted in higher charges in the ED compared with no antibiotic prescription. Conclusion: Acute diarrhea management in our ED is suboptimal and does not adhere to practice guidelines, resulting in unnecessary antibiotic prescriptions, investigations, and cost. |
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| MeSH term(s) | Academic Medical Centers ; Adolescent ; Adult ; Anti-Bacterial Agents/therapeutic use ; Cross-Sectional Studies ; Diarrhea/drug therapy ; Emergency Service, Hospital ; Humans ; Middle Aged ; Retrospective Studies ; Tertiary Healthcare ; Young Adult |
| Chemical Substances | Anti-Bacterial Agents |
| Language | English |
| Publishing date | 2022-08-02 |
| Publishing country | England |
| Document type | Journal Article |
| ZDB-ID | 184023-x |
| ISSN | 1473-2300 ; 0300-0605 ; 0142-2596 |
| ISSN (online) | 1473-2300 |
| ISSN | 0300-0605 ; 0142-2596 |
| DOI | 10.1177/03000605221115385 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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