Background Antibiotic Stewardship Programmes (ASP) help clinicians improve the quality of patients care by optimising the treatment of infections and reducing adverse events related to the use of antibiotics.
Purpose To evaluate the activity of the ASP since its implementation.
Material and methods This was a retrospective description of the activity of ASP in an acute care hospital and in an intermediate care unit, from June 2015 to September 2016. The multidisciplinary team was formed of a clinical pharmacist, microbiologist and two infectious diseases experts. The team met once a week and reviewed selected antibiotic treatments: restricted use according to the antibiotic policy guideline of the hospital, unusual doses or associations and antibiotic candidates for therapeutic drug monitoring. All interventions were agreed with the responsible clinician before modifying the treatment, and then registered in the electronic prescription programme (EPP).
Results 227 patients were evaluated; 121 (53%) women, mean age 77 years. Compliance of the team to weekly meeting was 78%; in each session an average of 4 patients were reviewed. 543 interventions were done, a mean of 2.4 interventions per patient, 348 in the acute care hospital (220 in medical departments, 115 in surgical departments and 13 in the emergency department) and 195 in Intermediate care unit.
Interventions were classified as follows: renal impairment dose adjustment 26% (142); change in antibiotic 15% (79); change in dose, frequency and/or duration of antibiotic 17% (95); antibiotic removal 13% (70); switch from intravenous to oral therapy 6% (32); therapeutic drug monitoring 3% (17); and antibiotic treatment that needs to be monitored 20% (108). 26 drugs were involved in the interventions. Five groups of antibiotics were involved in 55% of the interventions: quinolone 29%, cephalosporin 23%, aminoglycoside 18%, carbapenem 16% and vancomycin 13%.
Conclusion The multidisciplinary team allowed global control of treatments and more effective communication with prescribers. More than one-third of the interventions were due to dose adjustment in renal impairment or protocol non-compliance. The fact that a small group of drugs were related to more than half of the interventions allows us to focus on future interventions. It might be useful to relate these results to health related results.
No conflict of interest
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