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Updated: Apr 28, 2026

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
Published on: August 30, 2018
Correction: Antimicrobial stewardship in patients recently transferred to a ward from the ICU
A Ramos1, L Benitez-Gutierrez, A Asensio
1Antonio Ramos, Department of Internal Medicine (Infectious Diseases Unit). Hospital Universitario Puerta de Hierro. Universidad Autónoma de Madrid, Maestro Rodrigo nº 2. 28222 Majadahonda, Madrid. Spain. aramos220@gmail.com.
Unlabelled:
This paper is a corrigendum to the previously published paper: "Antimicrobial stewardship in patients recently transferred to a ward from the ICU" [Rev Esp Quimioter. 2014 Mar;27(1):46-50.] This corrigendum was prepared in order to correct some erroneous comments included in the discussion section. First, it should be pointed out that there could have been several suitable options for treating many infections and that, therefore, the word "inadequate" was not the most appropriate in this situation. In addition, some comments about the interpretation of microbiological results made by ICU physicians have been removed from the first article because this variable was not included in the study. Finally, another change made to the discussion was to clarify the ICU physicians' alleged low level of compliance with advice given by infectious disease specialists. This has been suggested in previous studies it cannot be substantiated when analyzing the results of the study.
Purpose:
Inappropriate use of antibiotics is an important health problem that is related to increasing bacterial resistance. Despite its relevance, many health institutions assign very limited resources to improving prescribing practices. An antimicrobial stewardship programme (APS) centred on patients discharged from the ICU could efficiently undertake this task.
Methods:
During this six month study the main activity was performing a programmed review of antimicrobial prescriptions in patients transferred to the ward from the ICU. In the case of amendable antimicrobial treatment, a recommendation was included in the medical record.
Results:
A total of 437 antimicrobial prescriptions for 286 patients were revised during a six month period and a total of 271 prescriptions (62%) in 183 patients were considered to be amendable. In most of these cases, treatment could have been reduced taking into consideration each patient's clinical improvement and their location in a hospital area with a lower risk of infection due to resistant bacteria. The most common advice was antimicrobial withdrawal (64%), antimicrobial change (20%) and switching to oral route (12%). Proposed recommendations were addressed in 212 cases (78%). There was no significant difference in adherence with respect to the type of recommendation (p=0.417). There was a 5% lower use of antibiotics during the year the study was conducted compared to the previous one.
Conclusions:
ASPs centred on patients discharged from the ICU may be an efficient strategy to ameliorate antimicrobial use in hospitals.
Insights
Implementing an antimicrobial stewardship programme (APS) for ICU patients reduced antibiotic use by 5%. This strategy efficiently improves prescribing practices and combats bacterial resistance.
Area of Science:
- Infectious Diseases
- Hospital Pharmacy
- Public Health
Background:
- Inappropriate antibiotic use drives bacterial resistance, a significant global health issue.
- Limited resources are often allocated to improving antibiotic prescribing practices in healthcare institutions.
- Antimicrobial stewardship programmes (ASPs) can be a cost-effective solution to optimize antibiotic use.
Purpose of the Study:
- To evaluate the effectiveness of an antimicrobial stewardship programme (APS) focused on patients transferred from the ICU to general wards.
- To assess the impact of the APS on antibiotic prescribing patterns and overall antibiotic consumption.
Main Methods:
- A six-month prospective study involving programmed review of antimicrobial prescriptions for patients transferred from the ICU.
- Recommendations for amendable antimicrobial treatments were documented in medical records.
- Analysis of prescription modifications, adherence to recommendations, and overall antibiotic usage trends.
Main Results:
- 62% of 437 reviewed prescriptions (286 patients) were amendable, suggesting potential for optimization.
- Common recommendations included antimicrobial withdrawal (64%), change (20%), and oral switch (12%).
- 78% of recommendations were addressed, with no significant difference in adherence based on recommendation type. A 5% reduction in antibiotic use was observed.
Conclusions:
- Antimicrobial stewardship programmes targeting ICU-discharged patients are an efficient strategy for optimizing hospital antibiotic use.
- These programmes can contribute to reducing overall antibiotic consumption and potentially mitigate the development of bacterial resistance.
- The study highlights the feasibility and positive impact of focused stewardship interventions.
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