Evaluation of the effect of refined management of prospective prescription review rules for antimicrobial agents in an outpatient setting of a county-level hospital in China

OBJECTIVE: To explore the impact of implementing a refined management system for prospective prescription review and to provide evidence for improving the rational use of antibiotics in county-level hospitals. METHODS: Using the prospective prescription review system at Affiliated Yangming Hospital of Ningbo University, China, we performed a refined management of the review rules targeting major issues identified in outpatient antibiotic prescriptions. A comparative analysis was conducted to evaluate the rationality of prescriptions before and after the implementation of this refined management. RESULTS: Comparison of prescription data before and after the refined management showed that the rate of irrational outpatient antibiotic prescriptions decreased from 20.46% to 7.80%. Specifically, the proportion of prescriptions with inappropriate indications decreased from 2.65% to 0.67%. The rate of prescriptions with an inappropriate frequency of administration or unsuitable solvent decreased from 4.63% to 0.79%. Prescriptions with an inappropriate dosage or route decreased from 8.14% to 2.09%. Irrational prescriptions for special populations decreased from 1.36% to 1.21%, and those involving potential drug-drug interactions decreased from 3.68% to 3.03%. CONCLUSION: The refined management of prospective antibiotic prescription review rules in the outpatient department of this county-level hospital significantly reduced the rate of irrational prescriptions. This strategy is worthy of promotion and application in other similar hospitals.