Background Pressure ulcers are a painful, debilitating and potentially serious outcome of failures of routine medical and nursing care, which represent a significant unnecessary cost to the healthcare system. In contrast with other adequately described guidelines (e.g. positioning, support surfaces, nutrition, wound dressings), limited data concerning the systematic use of antibiotics in these cases has been reported.
Purpose To investigate the use of antibiotics in patients with severe pressure ulcers (of grade 3 or 4) being nursed in a hospital ward, specialised in admitting patients who require prolonged continuation of treatment (after having been hospitalised in an acute care facility).
Material and methods Data concerning antibiotic consumption (converted to daily defined doses, DDDs) in this clinic in the year 2013 was extracted from the hospital pharmacy Data Information System. Data concerning antibiotic use in the group of patients under investigation, was compared to the total antibiotic consumption in this clinic over the same period of time, to generate percentages of antibiotic use these patients.
Results Although only 2.5% of inpatients (though accounting for the 10% of occupied bed days) suffered from pressure ulcers of grade 3 or 4 at the time of their admittance for continuation of treatment, they required a significant percentage of the total DDDs of antibiotics consumed in that clinic, e.g. 90% of colimycin, 71.5% of piperacillin/tazobactam, 100% of teicoplanin, 100% of cefepime, 87% of amoxicillin/clavulanic, 62% of vancomycin, 37% of meropenem, 44% of ceftazidime and 43% of clindamycin.
Conclusion Given the concomitant morbidities in these patients, it is difficult to define pressure ulcers as the primary indication for the systematic use antibiotics; however the presence of an ulcer of such a grade is substantially equivalent to a life-threatening infection, hence is in accordance with the high antibiotic consumption reported.
References and/or acknowledgements No conflict of interest.
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