Unexpected impact of infectious diseases division interventions on antibiotic use in two intensive care units
Abstract number: P1285
Cherifi S., Massaut J., Mascart G., Jamart S., Karmali R.
Objectives: The purpose of the present study was to estimate the impact of infectious diseases division interventions on the antibiotic use in two intensive care units (ICU) (12 beds of medical intensive care (MIC) and 12 beds of surgical intensive care (SIC) in a Belgium University hospital between 2003 and 2007.
Methods: One infectious diseases specialist with one microbiologist specialist constituted the infectious disease division and their main goals were twofold: 1) a reduction in the amount of broad spectrum antibiotics (including 3rd generation cephalosporins, cefepim, meropenem, aztreonam and piperacillin/tazobactam), fluoroquinolones, glycopeptides and aminoglycosides administered; 2) a cutback on the length of empirical treatment. The interventions started in 2005 with quality rounds (twice a week).
Antibiotic consumption data were obtained from the pharmacy and expressed as the number of DDDs (Daily Dose Defined) per 100 bed days.
Results: The interventions of the infectious diseases division resulted in an increase of total antibiotic consumption in SIC from 224 DDDs/100 bed days in 2005 to 281 in 2007 whereas a decrease from 492 to 334 DDDs was observed in MIC during the same period. In both intensive care units, the use of amoxicillin/clavulanic acid increased, particularly in SIC from 65 to 139 DDDs, while the proportion of broad spectrum antibiotics given decreased significantly. Aminoglycosides remained stable in both ICU whereas glycopeptides and fluroquinolones decreased in MIC.
Conclusions: The overall antibiotic consumption in SIC increased dramatically due to a progressive evolution towards a polyvalent intensive care with a mixture of surgical and medical pathologies. The pressure exerted by the intervention division on the ICU physicians led to a decrease use in broad spectrum antibiotics but at the expense of a spectacular increase in the consumption of amoxicillin/clavulanic acid. These preliminary data encouraged us to continue the collaboration with intensive care physicians and should prompt us to think on the real need of antibiotic therapy even in the ICU setting.
|Session name:||18th European Congress of Clinical Microbiology and Infectious Diseases|
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