RESUMO
We present the first description of an antimicrobial stewardship program (ASP) used to successfully manage a multi-antimicrobial drug shortage. Without resorting to formulary restriction, meropenem utilization decreased by 69% and piperacillin-tazobactam by 73%. During the shortage period, hospital mortality decreased (P=.03), while hospital length of stay remained unchanged. Infect Control Hosp Epidemiol 2017;38:356-359.
Assuntos
Antibacterianos/economia , Antibacterianos/provisão & distribuição , Gestão de Antimicrobianos , Mortalidade Hospitalar/tendências , Tempo de Internação/estatística & dados numéricos , Centros Médicos Acadêmicos , Humanos , Modelos Lineares , Meropeném , Missouri , Ácido Penicilânico/análogos & derivados , Ácido Penicilânico/provisão & distribuição , Piperacilina/provisão & distribuição , Combinação Piperacilina e Tazobactam , Estudos Retrospectivos , Tienamicinas/provisão & distribuiçãoRESUMO
Ceftazidime is the only anti-pseudomonal beta-lactam that has been reported to be administered by extended infusion in pediatric cystic fibrosis (CF) patients. A small pediatric pharmacokinetic/pharmacodynamic study has been published regarding the use of intermittent extended infusion doripenem in the treatment of an acute pulmonary exacerbation (APE) in pediatric CF patients; however, clinical use of intermittent extended infusion doripenem in pediatric CF patients has not been previously reported. We present three cases administering intermittent extended infusion doripenem in pediatric CF patients for the treatment of an APE in the case of replacing meropenem due to shortage. The delivery of beta-lactam antibiotics via intermittent extended infusion should be considered in order to optimize the pharmacodynamics of beta-lactams in the treatment of an APE.
