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Antibiotic stewardship and nosocomial infection prevention in critically ill patients: a quality improvement program.
Custódio, Nayá Saad; Machado, Luana Fernandes; Luckemeyer, Graziela Denardin; Syrio, Juliana Devós; Frutuoso, Isabela Shumaher; Chanes, Debora Augusto Valverde; Kaltenbacher, Luciana Tirelli; Braz, Melissa Maia; Nogueira, Mara Correa Lelles; Gandolfi, Joelma Villafanha; Lobo, Suzana Margareth.
Afiliação
  • Custódio NS; Faculty of Medicine of São José do Rio Preto - São José do Rio Preto (SP), Brazil.
  • Machado LF; Hospital de Base de São José do Rio Preto, Faculty of Medicine of São José do Rio Preto, Intensive Care Unit - São José do Rio Preto (SP), Brazil.
  • Luckemeyer GD; Hospital de Base de São José do Rio Preto, Faculty of Medicine of São José do Rio Preto, Intensive Care Unit - São José do Rio Preto (SP), Brazil.
  • Syrio JD; Hospital de Base de São José do Rio Preto, Faculty of Medicine of São José do Rio Preto, Intensive Care Unit - São José do Rio Preto (SP), Brazil.
  • Frutuoso IS; Hospital de Base de São José do Rio Preto, Faculty of Medicine of São José do Rio Preto, Intensive Care Unit - São José do Rio Preto (SP), Brazil.
  • Chanes DAV; Hospital de Base de São José do Rio Preto, Faculty of Medicine of São José do Rio Preto, Intensive Care Unit - São José do Rio Preto (SP), Brazil.
  • Kaltenbacher LT; Comissão de Controle de Infecção Hospitalar, Hospital de Base de São José do Rio Preto, Faculdade de Medicina de São José do Rio Preto - São José do Rio Preto (SP), Brazil.
  • Braz MM; Comissão de Controle de Infecção Hospitalar, Hospital de Base de São José do Rio Preto, Faculdade de Medicina de São José do Rio Preto - São José do Rio Preto (SP), Brazil.
  • Nogueira MCL; Faculty of Medicine of São José do Rio Preto - São José do Rio Preto (SP), Brazil.
  • Gandolfi JV; Faculty of Medicine of São José do Rio Preto - São José do Rio Preto (SP), Brazil.
  • Lobo SM; Faculty of Medicine of São José do Rio Preto - São José do Rio Preto (SP), Brazil.
Rev Assoc Med Bras (1992) ; 70(5): e20231282, 2024.
Article em En | MEDLINE | ID: mdl-38775503
ABSTRACT

OBJECTIVE:

The objective of this study was to evaluate the impact of the implementation of a bundle of interventions through a "Program for Antibiotic Management and Nosocomial Infection Prevention" in the intensive care unit on antibiotic and devices use and healthcare-associated infections.

METHODS:

This was a quasi-experimental study of consecutive series of cases in periods before and after the establishment of protocols and checklists for the use of antibiotics as well as other measures to prevent healthcare-associated infection as part of a quality improvement program. Antimicrobial consumption was assessed by the defined daily dose.

RESULTS:

A total of 1,056 and 1,323 admissions in the pre-intervention and post-intervention phases, respectively, were evaluated. The defined daily dose per 100 patient-day decreased from 89±8 to 77±11 (p=0.100), with a decrease in carbapenems, glycopeptides, polymyxins, penicillins, and cephalosporins. The rates of ventilator and central venous catheter use decreased from 52.8 to 44.1% and from 76 to 70%, respectively. The rates of healthcare-associated infection decreased from 19.2 to 15.5%.

CONCLUSION:

Quality improvement actions focused primarily on antimicrobial management and prevention of healthcare-associated infection are feasible and have the potential to decrease antibiotic use and healthcare-associated infection rates.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Infecção Hospitalar / Estado Terminal / Melhoria de Qualidade / Gestão de Antimicrobianos / Unidades de Terapia Intensiva / Antibacterianos Limite: Adult / Aged / Female / Humans / Male / Middle aged País/Região como assunto: America do sul / Brasil Idioma: En Revista: Rev Assoc Med Bras (1992) Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Brasil País de publicação: Brasil
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Infecção Hospitalar / Estado Terminal / Melhoria de Qualidade / Gestão de Antimicrobianos / Unidades de Terapia Intensiva / Antibacterianos Limite: Adult / Aged / Female / Humans / Male / Middle aged País/Região como assunto: America do sul / Brasil Idioma: En Revista: Rev Assoc Med Bras (1992) Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Brasil País de publicação: Brasil