Please use this identifier to cite or link to this item:
https://dipositint.ub.edu/dspace/handle/2445/202162
Title: | Reducing the duration of antibiotic therapy in surgical patients through a specific nationwide antimicrobial stewardship program. A prospective, interventional cohort study |
Author: | Batlle, Maria Badia, Josep M. Hernández, Sergi Grau, Santiago Padullés Zamora, Ariadna Boix Palop, Lucía Giménez Pérez, Montserrat Ferrer, Ricard Calbo, Esther Limon, Enrique Pujol, Miquel Horcajada Gallego, Juan Pablo Members of the 7VINCut Study Group |
Keywords: | Medicaments antibacterians Infeccions quirúrgiques Resistència als medicaments Antibacterial agents Surgical wound infection Drug resistance |
Issue Date: | 29-Jul-2023 |
Publisher: | Elsevier B.V. |
Abstract: | Background: Guidelines recommend 5-7 days of antibiotic treatment in patients with surgical infection and adequate source control. This nationwide stewardship intervention aimed to reduce the duration of treatments in surgical patients to <7 days. Methods: Prospective cohort study evaluating surgical patients receiving antibiotics ≥7 days in 32 hospitals. Indication for treatment, quality of source control, type of recommendations issued, and adherence to the recommendations were analysed. Temporal trends in the percentages of patients with treatment >7 days were evaluated using a linear regression model and Pearson's correlation coefficients. Results: A total of 32,499 patients were included. Of these, 13.7% had treatments ≥7 days. In all, 3,912 stewardship interventions were performed, primarily in general surgery (90.7%) and urology (8.1%). The main types of infection were intra-abdominal (73.4%), skin/soft tissues (9.8%) and urinary (9.2%). The septic focus was considered controlled in 59.9% of cases. Out of 5,458 antibiotic prescriptions, the most frequently analysed drugs were piperacillin/tazobactam (21.7%), metronidazole (11.2%), amoxicillin/clavulanate (10.3%), meropenem (10.7%), ceftriaxone (9.3%) and ciprofloxacin (6.7%). The main recommendations issued were: treatment discontinuation (35.0%), maintenance (40.0%) or de-escalation (15.5%), and the overall adherence rate was 91.5%. With adequate source control, the most frequent recommendation was to terminate treatment (51.2%). Throughout the study period, a significant decrease in the percentage of prolonged treatments was observed (Pc=-0.69;p<0.001). Conclusions: This stewardship programme reduced the duration of treatments in surgical departments. Preference was given to general surgery services, intra-abdominal infection, and beta-lactam antibiotics, including carbapenems. Adherence to the issued recommendations was high. |
Note: | Reproducció del document publicat a: https://doi.org/10.1016/j.ijantimicag.2023.106943 |
It is part of: | International Journal of Antimicrobial Agents, 2023, vol. 62, num. 5 |
URI: | http://hdl.handle.net/2445/202162 |
Related resource: | https://doi.org/10.1016/j.ijantimicag.2023.106943 |
ISSN: | 0924-8579 |
Appears in Collections: | Articles publicats en revistes (Infermeria de Salut Pública, Salut mental i Maternoinfantil) Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL)) |
Files in This Item:
File | Description | Size | Format | |
---|---|---|---|---|
739405.pdf | 726.43 kB | Adobe PDF | View/Open |
This item is licensed under a Creative Commons License