Journal Information
Vol. 33. Issue 1.
Pages 48-52 (January 2009)
Vol. 33. Issue 1.
Pages 48-52 (January 2009)
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Work of a multidisciplinary team in the control of the prescription of ertapenem
Actuación de un equipo multidisplinario en el control de la prescripción de ertapenem
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2001
M.V. Gil-Navarroa,
Corresponding author
mvnagil@hotmail.com

Corresponding author.
, R. Muñoz-Cortea, M. Herrero Romerob, M.D. Santos Rubioa, E. Cordero Matíab, J. Bautista Palomaa
a Unidad de Gestión Clínica de Farmacia, Hospitales Universitarios Virgen del Rocío, Sevilla, Spain
b Unidad de Gestión Clínica de Enfermedades Infecciosas, Hospitales Universitarios Virgen del Rocío, Sevilla, Spain
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Abstract
Objective

To determine the effectiveness of the intervention of a multidiscipline antimicrobial control group in the correct prescription of Ertapenem.

Method

A 4-month long, prospective study into prescriptions for ertapenem was carried out in a third-level hospital. Assessment into the degree of suitability of each prescription according to the infections commission usage criteria. In the situation where prescriptions were not suitable, recommendations were given and acceptance of this was recorded. The effectiveness of the antimicrobial treatment used was assessed and treatment was considered effective when there was remission of the signs and symptoms of the infection when the treatment was completed. The treatment was considered to have failed when the signs and symptoms of infection persisted or progressed, requiring the addition of another antimicrobial agent, changing antibiotics or the prolongation of the treatment for longer than 2 weeks. Lastly, the differences in the average length of stay and the duration of the antibiotic treatment between groups were analysed.

Results

Forty-eight prescriptions were assessed. The usage criterion was adequate in 48% of cases, with 78% effectiveness in this group. In the cases where the prescription was not adequate, but a change in prescription was accepted, the effectiveness was 92%, with 55.5% of those cases not accepting recommendation for change. The average stay was higher in this last group (P=.07). The duration of the antibiotic treatment in the patients who accepted the change in prescription was significantly less than in those who did not accept it (2 vs 7.4 days, P<.0001).

Conclusions

The control of ertapenem prescriptions by a multidisciplinary group was effective.

Keywords:
Ertapenem
Antibiotics
Antimicrobial management team
Antibiotics policies
Resistance to antibiotics
Resumen
Objetivo

Determinar la efectividad de la intervención de un grupo multidisciplinario de control antimicrobiano en la correcta prescripción de ertapenem.

Método

Estudio prospectivo, durante un período de 4 meses, de las prescripciones de ertapenem realizadas en un hospital de tercer nivel. Evaluación del grado de adecuación de cada prescripción a los criterios de utilización de la comisión de infecciones. En las situaciones en las que no se adecuaban, se emitió una recomendación y se registró la aceptación de éstas. Se evaluó la efectividad del tratamiento antimicrobiano utilizado; para ello, se consideró tratamiento efectivo cuando hubo remisión de los signos y los síntomas de la infección al finalizar el tratamiento. Se consideró fracaso del tratamiento cuando los signos y los síntomas de la infección persistieron o progresaron, requiriendo la adición de otro antimicrobiano, la sustitución por otro/s antibiótico/s o la prolongación del tratamiento más allá de 2 semanas. Finalmente, se analizaron las diferencias de estancia media y duración de tratamiento antibiótico entre los grupos.

Resultados

Se evaluaron 48 prescripciones. Se adecuaron a los criterios de uso un 48% de éstas, con una efectividad del 78% en este grupo. En los casos en los que la prescripción no se adecuó, pero se aceptó un cambio de tratamiento, la efectividad fue del 92%, y fue del 55,5% en los casos en los que no se aceptó esta recomendación. La tendencia de la estancia media fue mayor en este último grupo (p=0,07). La duración del tratamiento antibiótico en los pacientes en los que se aceptó el cambio fue significativamente menor que en los que no se aceptó (2 frente a 7,4 días; p<0,0001).

Conclusiones

El control de las prescripciones de ertapenem por un equipo multidisciplinario fue efectivo.

Palabras clave:
Ertapenem
Antibióticos
Equipo multidisciplinario antimicrobiano
Política antibiótica
Resistencia a antibióticos
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Partial results of this study were published as a scientific communication in poster format at the 42nd ASHP Midyear Clinical Meeting. Las Vegas, NV, December 2-6, 2007. RP930. [Accessed February 26, 2008.] Available from http://www.ashp.org/meetings/midyear/program/Posters-res.cfm.

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