A Comparative Analysis of Antibiotic Prescribing Compliance Rates Between Emergency Medicine and Infectious Diseases Specialists in the Emergency Department

Background: Antibiotic stewardship is crucial in the emergency department (ED) for optimizing patient outcomes and minimizing antimicrobial resistance. Understanding differences in antibiotic prescribing practices between emergency medicine (EM) and infectious diseases (ID) specialists can inform targeted interventions to enhance antibiotic use in the ED setting. This retrospective cross-sectional study aimed to compare antibiotic prescription compliance rates with established guidelines between EM and ID specialists within the ED. Methods: This retrospective cross-sectional study was conducted at Rasool Akram Hospital’s ED in 2022. Data from electronic health records and the prescription database were analyzed to compare antibiotic prescribing compliance rates between EM and ID specialists. Overall, 770 antibiotic prescriptions from the second half of 2022 were included in this study. Patient demographics, diagnoses, antibiotic details, and prescriber specialty were collected, and descriptive statistics were used to report the data. Finally, using chi-square or Fisher’s exact test, the subgroup analysis was considered to compare compliance rates between EM and ID specialists. Results: Of 770 patients with suspected infections, the ED prescribed antibiotics for 436 (56.6%). Levofloxacin was the most frequent ED antibiotic choice. ID specialists prescribed antibiotics less frequently for 157 patients (20.4%), favoring broad-spectrum combinations such as meropenem+vancomycin. In 38 cases (4.93%), ID specialists discontinued antibiotics initiated by the ED. This frequently involved discontinuing levofloxacin after a revised diagnosis of viral infection. There was low agreement between ED and ID specialists on antibiotic prescribing decisions (kappa: 0.095, P>0.05). Conclusion: Enhanced collaboration between EM and ID, including rapid diagnostics, tailored protocols, and targeted education, could optimize antibiotic prescribing in the ED. This has the potential to improve patient outcomes and combat antibiotic resistance.