Background In 2012, treatment protocols were agreed for the most common infections (pneumonia, urinary tract, bacteraemia and intra-abdominal catheter), approved by the relevant Committees and implemented in the Intensive Care Unit (ICU).
Purpose This study aims to assess the impact on mortality, the financial situation and the profile of antimicrobial prescribing in the ICU before and after implementing the protocols.
Material and methods Retrospective observational study comparing 2012 with 2013.
The average cost of drugs was used for the financial assessment; we did not include associated indirect costs, nor the possible variation between the number of stays.
The number of defined daily doses per 100 admissions (DDD/100 BD) was used to assess the prescription profile. DDD/Total 100 bed days were calculated, including all antimicrobials of the J01, J02 and J03 groups, and antimicrobials considered particularly relevant: carbapenems (imipenem and meropenem), linezolid, daptomycin, tigecycline and echinocandins (caspofungin and anidulafungin).
Results The overall antimicrobial consumption was reduced by 17.3% (221.5 vs. 183.2 DDD/100 BD) and costs decreased by 23.9% (€257,476 vs. €195,891).
The consumption of all antimicrobials studied reduced in 2013: 17.4% carbapenems (36.99 vs. 30.55 DDD/100 BD), linezolid 38.6% (3.76 vs. 2.31 DDD/100 BD), daptomycin 82.2% (2.86% vs. 0.51 DDD/100 BD), tigecycline 64.9% (4.98 vs. 1.75 DDD/100 BD) and echinocandins 13.8% (3.61 vs. 3 11 DDD/100 BD).
ICU mortality was 12.8% in 2012 and 10.9% in 2013.
Conclusion Antibiotic treatment protocols in the ICU have resulted in significant antibiotics savings, not only in financial terms but also in number of doses, without increasing mortality. This effect may be relevant to the need to optimise their use in order to prolong their useful life and reduce the selection of resistant organisms. In turn, protocols might be useful to reduce the variability of prescriptions.
References and/or Acknowledgements No conflict of interest.
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