Background and importance Antibiotic stewardship programmes (ASPs) aim to improve clinical outcomes in patients with infections and reduce adverse effects related to the use of these drugs, including the emergence of bacterial resistance.
In cancer patients, the development of infections is one of the most important causes of morbidity and mortality, which is why the consumption of antimicrobials is notable in this group of patients. For this reason, it is essential to optimise antimicrobial treatment both in therapeutic target and duration.
Aim and objectives To describe the actions carried out by the ASP in the oncology unit and analyse the degree of acceptance of these interventions.
Material and methods Prospective single-centre study to evaluate the interventions carried out by non-imposing counselling of the ASP team. The duration of the study was 3 months (April-July2021). During this period all inpatient antimicrobial prescriptions from the oncology unit were reviewed in a weekly meeting.
The intervention consisted of an evaluation of the adequacy of the prescription to the hospital antibiotherapy guide, review of the risk factors for multidrug-resistant microorganisms, and verification of the concordance between prescribed dose and renal function. In the case of discrepancy, an individualised proposal is made in a multidisciplinary meeting made up of experts from oncology, infectious diseases and pharmacy.
Demographic, biochemical, microbiological and clinical variables of the patient are collected through the electronic medical record.
Results Sixty-seven patients (51% female) with mean age 62±11 years were included. A total of 101 antimicrobials corresponding to 85 prescriptions were reviewed.
The most prescribed antibiotics were piperacillin/tazobactam (22), ceftriaxone (16), cotrimoxazole (15), amoxicillin/clavulanate (8) and metronidazole (5).
The sources of infection were respiratory (26.2%), urinary (21.3%), intra-abdominal (21.3%), skin and soft tissue (9.8%), catheter-associated (6.6%) and unclear (14.8%).
Recommendations were made to continue treatment (67.8%), discontinue for excessive duration (10.3%), de-escalate (9.2%), discontinue for unnecessary antimicrobial (8.0%) and escalate (4.6%).
The acceptance rate was 98.8%.
Conclusion and relevance The recommendations made by the ASP team were almost entirely accepted by the responsible clinician. Advice from a multidisciplinary team of experts in the field benefits these patients in optimising their antimicrobial therapy.
Conflict of interest No conflict of interest
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