ABSTRACT
Introducción: Adecuar la duración del tratamiento antibiótico es uno de los puntos claves de los programas de optimización del uso de antimicrobianos (PROA) dada la relación entre el riesgo de aparición de resistencias con los días de exposición a antimicrobianos. Métodos: Monitorización de tratamientos antibióticos por vía intravenosa de > 7 días de duración en el Hospital Infantil Vall dHebron, Barcelona, mediante cortes transversales semanales durante 24 semanas, con recomendaciones posteriores a los prescriptores para adecuar su uso. Resultados: Se realizaron 190 revisiones de 146 tratamientos antibióticos prolongados, prescritos en 81 pacientes. El 78,7% de prescripciones fueron adecuadas. Se realizaron 36 intervenciones sobre las prescripciones inadecuadas, con 52,7% de adaptación a la recomendación. Se optimizaron 19 tratamientos (14 suspendidos, 5 desescalados) reduciendo su duración un 8,75%. Conclusiones: La intervención activa del grupo PROA-NEN permite mejorar la adecuación antibiótica, reduciendo los tratamientos innecesariamente prolongados, especialmente en ámbitos con mayor margen de mejora.(AU)
Introduction: the duration adequacy of antibiotic regimens is one of the key points of Antimicrobial Stewardship Programs (ASP) given the relationship between the risk of resistance and days of exposure to antimicrobials. Methods: monitoring activities of intravenous antibiotics longer than 7 days at Hospital Infantil Vall dHebron, Barcelona, by reviewing data over a 34-weeks period from weekly cross-sectional analysis, followed by recommendations to prescribers to adapt their use. Results: a total of 81 patients with 146 prolonged intravenous antibiotic treatments (78.8% of prescriptions were adequate) were reviewed. A total of 190 revisions were performed. 36 interventions on inappropriate prescriptions were carried out (52.7% of adherence to recommendation). Nineteen treatments were optimized (14 suspended, 5 de-escalated) reducing their duration by 8.75%. Conclusions: active intervention of ASP group is an effective tool to improve antibiotic optimization, reducing unnecessarily prolonged treatments, mainly on these areas with a greater range of improvement.(AU)
Subject(s)
Anti-Infective Agents , Antimicrobial Stewardship , Anti-Bacterial Agents/pharmacology , Inappropriate Prescribing/prevention & control , Anti-Bacterial Agents/therapeutic use , Microbiology , Communicable Diseases , Spain , PediatricsABSTRACT
INTRODUCTION: the duration adequacy of antibiotic regimens is one of the key points of Antimicrobial Stewardship Programs (ASP) given the relationship between the risk of resistance and days of exposure to antimicrobials. METHODS: monitoring activities of intravenous antibiotics longer than 7 days at Hospital Infantil Vall d'Hebron, Barcelona, by reviewing data over a 34-weeks period from weekly cross-sectional analysis, followed by recommendations to prescribers to adapt their use. RESULTS: a total of 81 patients with 146 prolonged intravenous antibiotic treatments (78.8% of prescriptions were adequate) were reviewed. A total of 190 revisions were performed. 36 interventions on inappropriate prescriptions were carried out (52.7% of adherence to recommendation). Nineteen treatments were optimized (14 suspended, 5 de-escalated) reducing their duration by 8.75%. CONCLUSIONS: active intervention of ASP group is an effective tool to improve antibiotic optimization, reducing unnecessarily prolonged treatments, mainly on these areas with a greater range of improvement.
