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Revista de la OFIL
On-line version ISSN 1699-714XPrint version ISSN 1131-9429
Abstract
LALLANA-SAINZ, E et al. Antimicrobial stewardship programs: analysis of indicators of antimicrobial agents based on consumption. Rev. OFIL·ILAPHAR [online]. 2021, vol.31, n.4, pp.386-391. Epub Sep 19, 2022. ISSN 1699-714X. https://dx.doi.org/10.4321/s1699-714x20210004000010.
Objectives:
Implementation of a program for optimizing the use of antibiotics (PROA) to manage the use of antimicrobials. Analyse the impact through indicators based on consumption.
Methods:
Phase 1. Creation of PROA: appointment; external advice; training; software development. Phase 2. Consumption indicators analysis: interventional, quasi-experimental, retrospective study with pre-post evaluation: indicators based on consumption were evaluated in non-intervention phase and in intervention phase. PROA consisted of a non-restrictive intervention model.
Results:
PROA was formed and implemented as a structural and managing body for the advice, intervention and monitoring of the use of antimicrobials. During the intervention phase, 134 recommendations related to sequential therapy IV/PO (12.69%), change of antimicrobial/de-escalation (31.34%), discontinuation of antimicrobial treatment (55.97%) were made; the degree of acceptance was 67.16%. 13 indicators based on consumption were analysed. 11 of them led to an improvement: antibacterials global consumption (-2.26%), systemic antifungals global consumption (-40.60%), carbapenems consumption (-22.63%), fluoroquinolones consumption (-16.52%), macrolide IV/fosfomycin consumption (69.21%), antiMSSA agents/anti-MRSA agents ratio (45.14%), amoxicillin-clavulanic/piperacillin-tazobactam ratio (24.38%), diversification antipseudomonic beta-lactam (7.61%), fluconazole/echinocandins ratio (8.74%). Indicators with negative result were: sequential therapy IV/PO (-8.89%), amoxicillin/amoxicillin-clavulanic ratio (-4.03%).
Conclusions:
The results obtained show the effectiveness of PROA at our hospital when evaluating indicators based on consumption and allowing to measure the impact of the interventions made, identify the most effective strategies and prioritize the interventions to be carried out in the future.
Keywords : Anti-infective agents; quality indicators; health care; antimicrobial stewardship; drug utilization review; drug resistance; microbial.