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Ruiz J, Ramirez P, Gordon M, et al. Antimicrobial stewardship programme in critical care medicine: A prospective interventional study. Med Intensiva (Engl Ed). 2017;42(5):266-273doi: 10.1016/j.medin.2017.07.002.
Ruiz, J., Ramirez, P., Gordon, M., Villarreal, E., Frasquet, J., Poveda-Andres, J. L., Salavert-Lletí, M., & Catellanos, A. (2018). Antimicrobial stewardship programme in critical care medicine: A prospective interventional study. Medicina intensiva, 42(5), 266-273. https://doi.org/10.1016/j.medin.2017.07.002
Ruiz, J, et al. "Antimicrobial stewardship programme in critical care medicine: A prospective interventional study." Medicina intensiva vol. 42,5 (2018): 266-273. doi: https://doi.org/10.1016/j.medin.2017.07.002
Ruiz J, Ramirez P, Gordon M, Villarreal E, Frasquet J, Poveda-Andres JL, Salavert-Lletí M, Catellanos A. Antimicrobial stewardship programme in critical care medicine: A prospective interventional study. Med Intensiva (Engl Ed). 2018 Jun - Jul;42(5):266-273. doi: 10.1016/j.medin.2017.07.002. Epub 2017 Sep 04. Spanish. PMID: 28882325.
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Med Intensiva (Engl Ed). 2018 Jun - Jul;42(5):266-273. doi: 10.1016/j.medin.2017.07.002. Epub 2017 Sep 04.

Antimicrobial stewardship programme in critical care medicine: A prospective interventional study.

Medicina intensiva

[Article in Spanish]
J Ruiz, P Ramirez, M Gordon, E Villarreal, J Frasquet, J L Poveda-Andres, M Salavert-Lletí, A Catellanos

Affiliations

  1. Intensive Care Unit, Hospital Universitario y Politecnico La Fe, Valencia, Spain.
  2. Intensive Care Unit, Hospital Universitario y Politecnico La Fe, Valencia, Spain. Electronic address: [email protected].
  3. Microbiology Department, Hospital Universitario y Politecnico La Fe, Valencia, Spain.
  4. Pharmacy Department, Hospital Universitario y Politecnico La Fe, Valencia, Spain.
  5. Infectious Disease Department, Hospital Universitario y Politecnico La Fe, Valencia, Spain.

PMID: 28882325 DOI: 10.1016/j.medin.2017.07.002

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.

Copyright © 2017 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

Keywords: Antibiotic resistance; Antibiotics; Antibióticos; Antimicrobial stewardship; Critical care; Paciente crítico; Resistencia bacteriana

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