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Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
Published on: August 30, 2018
[Perception of surgeons on the use of antimicrobial stewardships programs]
B Bonaga Serrano1, B Obón Azuara2, A Gonzalo Rodriguez3
1Servicio de Farmacia, Hospital Clínico Universitario, Zaragoza, España.
Introduction:
The misuse and overuse of antimicrobials can contribute to an increase in antimicrobial resistance, increasing the risk of infections caused by drug-resistant bacteria. Most common surgical pathologies are infectious (either primary or as a complication), often being over-treated. Exploring the perception of surgeons on the use of implementing Antimicrobial stewardship programs (ASPs) is relevant in order to adapt the program to local context.
Objective:
To determine the perception of surgeons on the management of infections and antibiotic (AB) prescription in a General Surgery Department (GSD).
Methods:
A cross-sectional and descriptive study was conducted using an anonymous questionnaire that was distributed to assess the aspects related to AB management.
Results:
A total of 42 questionnaires were completed, with a 65% response rate. The large majority (75%) considered that antimicrobial resistance was an important problem. The main situations considered with medium/high margin of improvement were: time from taking the specimen to receiving the results (70%), use of a wide spectrum AB, and excessive duration (88% and 89%), dose adjustment according to renal function (81%), unnecessary prolongation of intravenous AB treatment (87%) and excessive duration of it (89%), preference for intravenous AB administration until discharge of the patient (73%). There were also difficulties in ASP implementation, as well as established and solid AB patterns (84%) and the heterogeneity of the GSD (84%).
Conclusions:
Organisational aspects of the GSD constitute one of the problems to implement the ASPs. A specific multidisciplinary team has been constituted to address different training aspects. This will also serve as a forum of discussion of certain complex patients with difficulties in antibiotic management.
Insights
Antimicrobial resistance is a significant concern in surgery. Surgeons identified key areas for improvement in antibiotic management and highlighted organizational challenges in implementing antimicrobial stewardship programs (ASPs).
Area of Science:
- Infectious Diseases
- Surgical Infections
- Antimicrobial Resistance
Context:
- Surgical infections are common and often over-treated with antibiotics.
- Antimicrobial resistance is a growing global health threat.
- Understanding surgeon perceptions is crucial for effective antimicrobial stewardship.
Purpose:
- To assess surgeons' views on infection management and antibiotic prescribing in a General Surgery Department.
- To identify barriers to implementing antimicrobial stewardship programs (ASPs) in surgical settings.
Summary:
- A survey of 42 surgeons revealed widespread concern about antimicrobial resistance.
- Surgeons identified significant opportunities for improvement in antibiotic spectrum, duration, dosing, and administration.
- Organizational factors and established prescribing patterns pose challenges to ASP implementation.
Impact:
- Findings will inform the adaptation of ASPs to local surgical contexts.
- A multidisciplinary team will address training needs and complex antibiotic management cases.
- Improved antibiotic stewardship can mitigate the rise of drug-resistant bacteria in surgical patients.
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