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Formula to help select rational antimicrobial therapy (FRAT): its application to community- and hospital-acquired
1Saskatoon & District Health and St. Paul's Hospital (Grey Nuns) and the University of Saskatchewan, Canada. blondeauj@sdh.sk.ca
Abstract:
The selection of antimicrobial agents is guided by the use of formularies which often constrain prescribing options. There are several factors which influence the inclusion of specific agents. Two of the most important factors are microbial etiology of a disease and the incidence of antibiotic resistance. Various surveillance programs have highlighted the regional differences in antimicrobial susceptibility/resistance among various pathogens. This simple formula enables individual physicians, pharmacy and therapeutic committees and managed care formulary managers to harness local etiology and susceptibility information. In this paper the formula is applied to community- and hospital-acquired urinary tract infections.
Insights
Formularies guide antimicrobial selection, but local resistance data is key. A new formula helps prescribers and committees use local susceptibility information for better antimicrobial prescribing, especially for urinary tract infections.
Area of Science:
- Infectious Diseases
- Pharmacology
- Public Health
Background:
- Antimicrobial selection is often limited by formularies.
- Microbial etiology and antibiotic resistance significantly influence drug inclusion.
- Regional variations in pathogen susceptibility necessitate localized data.
Purpose of the Study:
- To introduce a formula for selecting antimicrobial agents based on local data.
- To enable physicians and committees to utilize local etiology and susceptibility information.
- To apply this formula to community- and hospital-acquired urinary tract infections.
Main Methods:
- Development of a formula incorporating local microbial etiology.
- Integration of regional antimicrobial susceptibility and resistance data.
- Application of the formula to urinary tract infection (UTI) case studies.
Main Results:
- The proposed formula provides a framework for evidence-based formulary decisions.
- Demonstrated utility in optimizing antimicrobial selection for UTIs.
- Highlights the importance of localized surveillance data.
Conclusions:
- A practical formula can enhance antimicrobial stewardship by leveraging local resistance patterns.
- This approach supports informed decision-making for formulary committees and prescribers.
- Local data integration is crucial for effective management of infectious diseases like UTIs.