Background Restricting the use of antibiotics at the hospital level is part of the rational use of these agents. Through a multidisciplinary process, their use is restricted to certain groups of patients or clinical situations to ensure greater efficiency, to avoid adverse effects and also for epidemiological reasons (such as antibiotic resistance).
Purpose The aim of this study was to analyse prescriptions of restricted antibiotics in the treatment of urinary tract infections (UTI).
Material and methods Retrospective observational study. Patients selected for this study had been diagnosed with UTI and treated with restricted antibiotics between April 2015 and May 2015.
The following information was collected: sex and age, prescribed antibiotic, origin of infection (nosocomial, community acquired or healthcare associated), analytical values (leukocytosis and PCR) and microbiological data (blood/urine cultures). Data collection was performed consulting the electronic prescribing software Farmatools, medical histories and microbiology database. Data were reviewed in collaboration with an infectious diseases specialist, who performed the corresponding interventions based on the indication, origin of infection, analytical and microbiological data, and information provided by the pharmacist.
Results 31 patients diagnosed with UTI and treated with restricted antibiotics were selected (32% women, median age 74 years). Restricted antibiotics prescribed were the following: ertapenem (61%), considered clinically indicated (CI) in 74% of prescriptions; meropenem (23%), being CI in 33% of prescriptions; aztreonam (10%), CI in 67% of prescriptions; imipenem (3%), CI in 100% of prescriptions; and linezolid (3%), not CI in any prescription
In general, it was considered that 35% of prescriptions were not clinically indicated. Regarding their origin, 42% of the infections were healthcare associated (urinary catheterisation), 35% community acquired and 23% of nosocomial origin.
Conclusion It was found that 1 in 3 restricted antibiotic prescriptions were not clinically indicated and most infections were healthcare associated. The guidelines are that indwelling urethral catheters should not be used unless necessary and should be removed within 24 h if possible. Misuse of antibiotics can lead to treatment failure, relapses and multidrug resistance, which requires continuous training of the medical team.
References and/or Acknowledgements Programmes for optimising the use of antibiotics in hospitals.
No conflict of interest.
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