Background and importance The prescriptions of new antibiotics should be done with caution as improper use can lead to the emergence of new antimicrobial resistance. The antimicrobial stewardship team (AST) and the commission of infections (CI) have a fundamental task of achieving adequate use of these drugs. It is important to establish a suitable circuit for the control of their prescriptions. Knowing how this circuit operates is essential to establish if it is necessary to make any modifications.
Aim and objectives To analyse the operation of the prescription/revision circuit for new antibiotics included in the pharmacotherapeutic guide, and to show the adequacy of the prescriptions of antibiotics recently included in the hospital’s pharmacotherapeutic guide.
Material and methods Inclusion criteria: prescriptions (January 2018 to September 2019) of ceftaroline, dalbavancin, ceftolozano/tazobactam, ceftazidime/avibactam, tedizolid and isavuconazole. Exclusion criteria: prescriptions in the intensive care unit (which has a different prescription circuit).
The CI and AST decided the indications for the new antibiotics and their prescription circuit. A non-restrictive attitude was decided. Prescription of these antibiotics could be carried out by any specialist, with or without prior advice from the AST. Prescriptions made without AST supervision were reviewed by the AST in 24–48 hours.
The information for review was obtained from medical and electronic prescription records.
Results A total of 28 prescriptions were reviewed: 39.3% (n=11) ceftazidime/avibactam, 28.6% (n=8) dalbavancin, 14.3% (n=4) ceftaroline, 7.2% (n=2) ceftolozano/tazobactam, 7.2% (n=2) isavuconazole and 3.4% (n=1) tedizolid. A total of 50% (n=14) of prescriptions were made by the AST and 50% (n=14) were performed by doctors who did not belong to the AST, of which 36% (n=5) had prior consultation with the AST and 64% (n=9) did not consult the AST.
Of the prescriptions that did not receive prior advice from the AST, 55.55% (n=5) were reviewed by the AST. All of the prescriptions (100%, n=14) made by the AST or under their supervision were within the indications established by the CI.
Five of 28 prescriptions were not adequate (2 isavuconazol, 2 ceftaroline, 1 tedizolid). These were prescriptions made without the advice or revision of the AST. Three of the incorrect prescriptions were in August 2018 and one in August 2019.
Conclusion and relevance In general, our circuit worked correctly. Some of the prescriptions out of indication were during the holiday period and not all AST members were working. Therefore, this team should operate at full capacity all year round. The adequacy of antibiotics is greater when there is AST prescription or intervention.
References and/or acknowledgements No conflict of interest.
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