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Y Moutaouakkil1,2, S Siah3, A Bennana4

  • 1Pôle Pharmacie, Hôpital Militaire d'Instruction Mohamed V, Faculté de Médecine et de Pharmacie, Université Mohamed V de Rabat, Maroc.

Annals of Burns and Fire Disasters
|September 4, 2018
PubMed
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Antibiotic therapy reassessment in burns intensive care units is crucial for public health. This study found that while reassessment occurred in 72% of cases, therapeutic de-escalation could have been more frequent, highlighting a need for improved antibiotic stewardship.

Area of Science:

  • Infectious Diseases
  • Critical Care Medicine
  • Pharmacology

Context:

  • Bacterial resistance and inappropriate antibiotic use pose significant global public health and economic challenges.
  • Burns intensive care units (ICUs) present unique challenges due to high infection rates and specific bacterial ecosystems.
  • A prospective study was conducted in the burns ICU at the Military Hospital Instruction Mohammed V of Rabat to evaluate antibiotic therapy practices.

Purpose:

  • To study the reevaluation of probabilistic antibiotherapy in a burns intensive care unit.
  • To assess the clinical-biological reassessment practices of antibiotic therapy at 48-72 hours post-prescription.
  • To identify opportunities for optimizing antibiotic use and improving antibiotic stewardship.

Summary:

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  • The study included 68 seriously ill septic patients (predominantly male, average age 36) admitted to the burns ICU over six months.
  • Antibiotic therapy reassessment was performed in 72.06% of cases, with 75% of treatments deemed justified.
  • Therapeutic de-escalation was underutilized, occurring in 11.76% of cases when potentially applicable in 36.76% of instances, often due to the presence of multidrug-resistant bacteria (MDRB).

    • Impact:

    • Highlights the essential role of clinico-biological re-evaluation of antibiotic therapy to combat antibiotic misuse.
    • Led to the implementation of targeted interventions, including appointing an infectious disease pharmacist, activating an Anti-Infectious Committee, and optimizing antibiotic dispensing.
    • Emphasizes the need for continuous monitoring and improvement of antibiotic stewardship programs in critical care settings.