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What is the best way to improve the quality of care for patients admitted to the hospital with respiratory tract infections?

Mark L Metersky

Evaluation of: Schouten JA, Hulscher MEJL, Trap-Liefers J et al.: Tailored interventions to improve antibiotic use for lower respiratory tract infections in hospitals: a cluster-randomized, controlled trial. Clin. Infect. Dis. 44, 931–941 (2007) [1]. This was a report of a multifaceted effort to improve the quality of antibiotic usage among patients admitted to three hospitals with lower respiratory tract infections. The strength of this report was the inclusion of a control group of three hospitals. Significant improvements relative to the control hospitals occurred in the usage of antibiotics consistent with guideline recommendations, adjustment of antibiotic dosage for renal dysfunction, the provision of antibiotics within 4 h and the use of short-course therapy. Improvements were not seen in the rate of use of recommended diagnostic tests and early switch to oral therapy.