Antimicrobial stewardship programme in critical care medicine: A prospective interventional study.
Med Intensiva (Engl Ed)
; 42(5): 266-273, 2018.
Article
em En, Es
| MEDLINE
| ID: mdl-28882325
ABSTRACT
OBJECTIVE:
Hospital antimicrobial stewardship programmes have achieved savings and a more rational use of antimicrobial treatments in general wards. The purpose of this report is to evaluate the experience of an antimicrobial stewardship programme in an intensive care unit (ICU).DESIGN:
Prospective interventional, before-and-after study. SCOPE 24-bed medical ICU in a tertiary hospital. INTERVENTION Prospective audit and feedback antimicrobial stewardship programme. ENDPOINTS Antimicrobial consumption, antimicrobial related costs, multi-drug resistant microorganisms (MDRM) prevalence, nosocomial infections incidence, ICU length of stay, and ICU mortality rates were compared before and after one-year intervention.RESULTS:
A total of 218 antimicrobial episodes of 182 patients were evaluated in 61 team meetings. Antimicrobial stewardship suggestions were accepted in 91.5% of the cases. Total antimicrobial DDD/100 patient-days consumption was reduced from 380.6 to 295.2 (-22.4%; p=0.037). Antimicrobial stewardship programme was associated with a significant decrease in the prescription of penicillins plus b-lactamase inhibitors, linezolid, cephalosporins, and aminoglycosides. Overall antimicrobial spending was reduced by 119,636. MDRM isolation and nosocomial infections per 100 patient-days did not change after the intervention period. No changes in length of stay or mortality rate were observed.CONCLUSIONS:
An ICU antimicrobial stewardship programme significantly reduced antimicrobial use without affecting inpatient mortality and length of stay. Our results further support the implementation of an antimicrobial stewardship programme in critical care units.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Cuidados Críticos
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Gestão de Antimicrobianos
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Unidades de Terapia Intensiva
Tipo de estudo:
Evaluation_studies
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Observational_studies
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Risk_factors_studies
Limite:
Female
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Humans
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Male
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Middle aged
Idioma:
En
/
Es
Revista:
Med Intensiva (Engl Ed)
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Espanha