Prescription quality of prolonged antibiotherapy in pediatrics. Impact of ASP program interventions
Susana Melendo1, Aurora Fernández-Polo2, Ivette Castellnou Asens1
1Unidad de Patología Infecciosa e Inmunodeficiencias de Pediatría, Servicio de Pediatría, Hospital Universitari Vall d'Hebron, Instituto de Investigación Vall d'Hebron (VHIR), Universidad Autónoma de Barcelona, Barcelona, España.
Insights
Antimicrobial Stewardship Programs (ASP) effectively optimize antibiotic use by monitoring prolonged intravenous treatments. Interventions reduced treatment duration, aiding in antimicrobial resistance prevention.
Area of Science:
- Infectious Diseases
- Clinical Pharmacy
- Antimicrobial Resistance
Background:
- Optimizing antibiotic regimen duration is crucial for Antimicrobial Stewardship Programs (ASP).
- Prolonged antibiotic exposure increases the risk of antimicrobial resistance.
- Effective monitoring strategies are needed to ensure appropriate antibiotic use.
Purpose of the Study:
- To evaluate the impact of active interventions by an ASP team on optimizing prolonged intravenous antibiotic treatments.
- To assess the adequacy of antibiotic prescriptions and identify areas for improvement.
Main Methods:
- A 34-week prospective study involving weekly cross-sectional analysis of intravenous antibiotic prescriptions longer than 7 days.
- Review of 146 prolonged antibiotic treatments in 81 patients.
- Interventions and recommendations provided to prescribers.
Main Results:
- 78.8% of reviewed antibiotic prescriptions were deemed adequate.
- 36 interventions were performed on inappropriate prescriptions, with 52.7% adherence.
- Nineteen treatments were optimized (14 suspended, 5 de-escalated), reducing duration by 8.75%.
Conclusions:
- Active ASP intervention is effective in optimizing antibiotic use.
- This approach successfully reduces unnecessarily prolonged antibiotic treatments.
- Targeted interventions can lead to significant improvements in antibiotic stewardship.
Introduction:
the duration adequacy of antibiotic regimens is one of the key points of Antimicrobial Stewardship Programs (ASP) given the relationship between the risk of resistance and days of exposure to antimicrobials.
Methods:
monitoring activities of intravenous antibiotics longer than 7 days at Hospital Infantil Vall d'Hebron, Barcelona, by reviewing data over a 34-weeks period from weekly cross-sectional analysis, followed by recommendations to prescribers to adapt their use.
Results:
a total of 81 patients with 146 prolonged intravenous antibiotic treatments (78.8% of prescriptions were adequate) were reviewed. A total of 190 revisions were performed. 36 interventions on inappropriate prescriptions were carried out (52.7% of adherence to recommendation). Nineteen treatments were optimized (14 suspended, 5 de-escalated) reducing their duration by 8.75%.
Conclusions:
active intervention of ASP group is an effective tool to improve antibiotic optimization, reducing unnecessarily prolonged treatments, mainly on these areas with a greater range of improvement.
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