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Predictors of inappropriate antimicrobial prescription: Eight-year point prevalence surveys experience in a third level hospital in Spain

Antibiotic stewardship programs (ASP) have already demonstrated clinical benefits. We aimed to describe the Point Prevalence Surveys (PPS) methodology implemented in our hospital as an efficient tool to guide ASP strategies. Annually repeated PPS were conducted from 2012 to 2019 at a 750-bed univers...

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Autores principales: Núñez-Núñez, María, Perez-Galera, Salvador, Girón-Ortega, José Antonio, Sandoval Fernández-Del-Castillo, Santiago, Beltrán-García, Margarita, De Cueto, Marina, Suárez-Barrenechea, Ana Isabel, Palacios-Baena, Zaira R., Terol-Barrero, Pedro, Oltra-Hostalet, Fernando, Arenzana-Seisdedos, Ángel, Rodriguez-Baño, Jesús, Retamar-Gentil, Pilar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9592087/
https://www.ncbi.nlm.nih.gov/pubmed/36299899
http://dx.doi.org/10.3389/fphar.2022.1018158
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author Núñez-Núñez, María
Perez-Galera, Salvador
Girón-Ortega, José Antonio
Sandoval Fernández-Del-Castillo, Santiago
Beltrán-García, Margarita
De Cueto, Marina
Suárez-Barrenechea, Ana Isabel
Palacios-Baena, Zaira R.
Terol-Barrero, Pedro
Oltra-Hostalet, Fernando
Arenzana-Seisdedos, Ángel
Rodriguez-Baño, Jesús
Retamar-Gentil, Pilar
author_facet Núñez-Núñez, María
Perez-Galera, Salvador
Girón-Ortega, José Antonio
Sandoval Fernández-Del-Castillo, Santiago
Beltrán-García, Margarita
De Cueto, Marina
Suárez-Barrenechea, Ana Isabel
Palacios-Baena, Zaira R.
Terol-Barrero, Pedro
Oltra-Hostalet, Fernando
Arenzana-Seisdedos, Ángel
Rodriguez-Baño, Jesús
Retamar-Gentil, Pilar
author_sort Núñez-Núñez, María
collection PubMed
description Antibiotic stewardship programs (ASP) have already demonstrated clinical benefits. We aimed to describe the Point Prevalence Surveys (PPS) methodology implemented in our hospital as an efficient tool to guide ASP strategies. Annually repeated PPS were conducted from 2012 to 2019 at a 750-bed university hospital in South Spain. Key quality indicators and inappropriateness of antimicrobial treatment, defined strictly according to local guidelines, were described. Variables associated with inappropriate treatment were identified by bi/multivariable analysis. A total of 1,600 patients were included. We found that 49% of the prescriptions were inappropriate due to unnecessary treatment (14%), not first line drug recommended (14%), inadequate drug according to microbiological results (9%), unsuitable doses (8%), route (3%) or duration (7%). Samples collection presented a significant protective effect together with sepsis presentation at onset and intensive care unit admission. However, age, receiving an empirical treatment and an unknown or urinary source of the infections treated were independent risk factors for inappropriateness. Site and severity of infection were documented in medical charts by prescribers (75 and 61% respectively). PPS may allow identifying the main risk factors for inappropriateness. This simple methodology may be useful for ASP to select modifiable factors to be prioritized for targeted interventions.
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spelling pubmed-95920872022-10-25 Predictors of inappropriate antimicrobial prescription: Eight-year point prevalence surveys experience in a third level hospital in Spain Núñez-Núñez, María Perez-Galera, Salvador Girón-Ortega, José Antonio Sandoval Fernández-Del-Castillo, Santiago Beltrán-García, Margarita De Cueto, Marina Suárez-Barrenechea, Ana Isabel Palacios-Baena, Zaira R. Terol-Barrero, Pedro Oltra-Hostalet, Fernando Arenzana-Seisdedos, Ángel Rodriguez-Baño, Jesús Retamar-Gentil, Pilar Front Pharmacol Pharmacology Antibiotic stewardship programs (ASP) have already demonstrated clinical benefits. We aimed to describe the Point Prevalence Surveys (PPS) methodology implemented in our hospital as an efficient tool to guide ASP strategies. Annually repeated PPS were conducted from 2012 to 2019 at a 750-bed university hospital in South Spain. Key quality indicators and inappropriateness of antimicrobial treatment, defined strictly according to local guidelines, were described. Variables associated with inappropriate treatment were identified by bi/multivariable analysis. A total of 1,600 patients were included. We found that 49% of the prescriptions were inappropriate due to unnecessary treatment (14%), not first line drug recommended (14%), inadequate drug according to microbiological results (9%), unsuitable doses (8%), route (3%) or duration (7%). Samples collection presented a significant protective effect together with sepsis presentation at onset and intensive care unit admission. However, age, receiving an empirical treatment and an unknown or urinary source of the infections treated were independent risk factors for inappropriateness. Site and severity of infection were documented in medical charts by prescribers (75 and 61% respectively). PPS may allow identifying the main risk factors for inappropriateness. This simple methodology may be useful for ASP to select modifiable factors to be prioritized for targeted interventions. Frontiers Media S.A. 2022-10-10 /pmc/articles/PMC9592087/ /pubmed/36299899 http://dx.doi.org/10.3389/fphar.2022.1018158 Text en Copyright © 2022 Núñez-Núñez, Perez-Galera, Girón-Ortega, Sandoval Fernández-Del-Castillo, Beltrán-García, De Cueto, Suárez-Barrenechea, Palacios-Baena, Terol-Barrero, Oltra-Hostalet, Arenzana-Seisdedos, Rodriguez-Baño and Retamar-Gentil. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pharmacology
Núñez-Núñez, María
Perez-Galera, Salvador
Girón-Ortega, José Antonio
Sandoval Fernández-Del-Castillo, Santiago
Beltrán-García, Margarita
De Cueto, Marina
Suárez-Barrenechea, Ana Isabel
Palacios-Baena, Zaira R.
Terol-Barrero, Pedro
Oltra-Hostalet, Fernando
Arenzana-Seisdedos, Ángel
Rodriguez-Baño, Jesús
Retamar-Gentil, Pilar
Predictors of inappropriate antimicrobial prescription: Eight-year point prevalence surveys experience in a third level hospital in Spain
title Predictors of inappropriate antimicrobial prescription: Eight-year point prevalence surveys experience in a third level hospital in Spain
title_full Predictors of inappropriate antimicrobial prescription: Eight-year point prevalence surveys experience in a third level hospital in Spain
title_fullStr Predictors of inappropriate antimicrobial prescription: Eight-year point prevalence surveys experience in a third level hospital in Spain
title_full_unstemmed Predictors of inappropriate antimicrobial prescription: Eight-year point prevalence surveys experience in a third level hospital in Spain
title_short Predictors of inappropriate antimicrobial prescription: Eight-year point prevalence surveys experience in a third level hospital in Spain
title_sort predictors of inappropriate antimicrobial prescription: eight-year point prevalence surveys experience in a third level hospital in spain
topic Pharmacology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9592087/
https://www.ncbi.nlm.nih.gov/pubmed/36299899
http://dx.doi.org/10.3389/fphar.2022.1018158
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