Feasibility of Antimicrobial Stewardship (AMS) in critical care settings: a multidisciplinary approach strategy

Detalhes bibliográficos
Autor(a) principal: Tiszai-Szucs, Tamas
Data de Publicação: 2018
Outros Autores: Mac Sweeney, Claire, Keaveny, Joseph, Bozza, Fernando A., Hagan, Zieta O., Martin-Loeches, Ignacio
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da FIOCRUZ (ARCA)
Texto Completo: https://www.arca.fiocruz.br/handle/icict/34155
Resumo: St James’s Hospital. Department of Anaesthesia and Critical Care Medicine. Dublin, Ireland.
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spelling Tiszai-Szucs, TamasMac Sweeney, ClaireKeaveny, JosephBozza, Fernando A.Hagan, Zieta O.Martin-Loeches, Ignacio2019-07-16T15:11:53Z2019-07-16T15:11:53Z2018TISZAI-SZUCS, Tamas et al. Feasibility of antimicrobial stewardship (AMS) in critical care settings: a multidisciplinary approach strategy. Medical Sciences, v. 6, n. 40, p. 1-8, 2018.2076-3271https://www.arca.fiocruz.br/handle/icict/3415510.3390/medsci60200402076-3271engMDPIFeasibility of Antimicrobial Stewardship (AMS) in critical care settings: a multidisciplinary approach strategyinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleSt James’s Hospital. Department of Anaesthesia and Critical Care Medicine. Dublin, Ireland.St James’s Hospital. Department of Anaesthesia and Critical Care Medicine. Dublin, Ireland.St James’s Hospital. Department of Anaesthesia and Critical Care Medicine. Dublin, Ireland.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.St James’s Hospital. Department of Anaesthesia and Critical Care Medicine. Dublin, Ireland.St James’s Hospital. Department of Anaesthesia and Critical Care Medicine. Dublin, Ireland / St James’s Hospital. Multidisciplinary Intensive Care Research Organization. Dublin, Ireland / Trinity Centre for Health Sciences. Dublin, Ireland / CIBER Enfermedades Respiratorias. Madrid, Spain.Antimicrobial resistance is escalating and triggers clinical decision-making challenges when treating infections in patients admitted to intensive care units (ICU). Antimicrobial stewardship (AMS) may help combat this problem, but it can be difficult to implement in critical care settings. The implementation of multidisciplinary AMS in ICUs could be more challenging than what is currently suggested in the literature. Our main goal was to analyze the reduction in duration of treatment (DOT) for the most commonly used antibacterial and antifungal agents during the first six months of 2014, and during the same period two years later (2016). A total of 426 and 424 patient encounters, respectively, were documented and collected from the intensive care unit’s electronic patient record system. Daily multidisciplinary ward rounds were conducted for approximately 30–40 min, with the goal of optimizing antimicrobial therapy in order to analyze the feasibility of implementing AMS. The only antimicrobial agent which showed a significant reduction in the number of prescriptions and in the duration of treatment during the second audit was vancomycin, while linezolid showed an increase in the number of prescriptions with no significant prolongation of the duration of treatment. A trend of reduction was also seen in the DOT for co-amoxiclavulanate and in the number of prescriptions of anidulafungin without any corresponding increases being observed for other broad-spectrum anti-infective agents (p-values of 0.07 and 0.05, respectively).ResistanceAntimicrobial stewardshipPneumoniaSepsisVentilator-associated pneumoniaIntensive care unitMultidrug resistanceStewardshipAntibioticsinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txttext/plain1748https://www.arca.fiocruz.br/bitstream/icict/34155/1/license.txt8a4605be74aa9ea9d79846c1fba20a33MD51ORIGINALve_Tiszai-Szucs_Tamas_etal_INI_2018.pdfve_Tiszai-Szucs_Tamas_etal_INI_2018.pdfapplication/pdf214041https://www.arca.fiocruz.br/bitstream/icict/34155/2/ve_Tiszai-Szucs_Tamas_etal_INI_2018.pdfd881ea813e0561540f5e3993e8f00a5eMD52TEXTve_Tiszai-Szucs_Tamas_etal_INI_2018.pdf.txtve_Tiszai-Szucs_Tamas_etal_INI_2018.pdf.txtExtracted texttext/plain29372https://www.arca.fiocruz.br/bitstream/icict/34155/3/ve_Tiszai-Szucs_Tamas_etal_INI_2018.pdf.txt67d3a0c0c530461d6c5a14ba68ac1a7bMD53icict/341552019-07-17 02:02:58.284oai:www.arca.fiocruz.br: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Repositório InstitucionalPUBhttps://www.arca.fiocruz.br/oai/requestrepositorio.arca@fiocruz.bropendoar:21352019-07-17T05:02:58Repositório Institucional da FIOCRUZ (ARCA) - Fundação Oswaldo Cruz (FIOCRUZ)false
dc.title.pt_BR.fl_str_mv Feasibility of Antimicrobial Stewardship (AMS) in critical care settings: a multidisciplinary approach strategy
title Feasibility of Antimicrobial Stewardship (AMS) in critical care settings: a multidisciplinary approach strategy
spellingShingle Feasibility of Antimicrobial Stewardship (AMS) in critical care settings: a multidisciplinary approach strategy
Tiszai-Szucs, Tamas
Resistance
Antimicrobial stewardship
Pneumonia
Sepsis
Ventilator-associated pneumonia
Intensive care unit
Multidrug resistance
Stewardship
Antibiotics
title_short Feasibility of Antimicrobial Stewardship (AMS) in critical care settings: a multidisciplinary approach strategy
title_full Feasibility of Antimicrobial Stewardship (AMS) in critical care settings: a multidisciplinary approach strategy
title_fullStr Feasibility of Antimicrobial Stewardship (AMS) in critical care settings: a multidisciplinary approach strategy
title_full_unstemmed Feasibility of Antimicrobial Stewardship (AMS) in critical care settings: a multidisciplinary approach strategy
title_sort Feasibility of Antimicrobial Stewardship (AMS) in critical care settings: a multidisciplinary approach strategy
author Tiszai-Szucs, Tamas
author_facet Tiszai-Szucs, Tamas
Mac Sweeney, Claire
Keaveny, Joseph
Bozza, Fernando A.
Hagan, Zieta O.
Martin-Loeches, Ignacio
author_role author
author2 Mac Sweeney, Claire
Keaveny, Joseph
Bozza, Fernando A.
Hagan, Zieta O.
Martin-Loeches, Ignacio
author2_role author
author
author
author
author
dc.contributor.author.fl_str_mv Tiszai-Szucs, Tamas
Mac Sweeney, Claire
Keaveny, Joseph
Bozza, Fernando A.
Hagan, Zieta O.
Martin-Loeches, Ignacio
dc.subject.en.pt_BR.fl_str_mv Resistance
Antimicrobial stewardship
Pneumonia
Sepsis
Ventilator-associated pneumonia
Intensive care unit
Multidrug resistance
Stewardship
Antibiotics
topic Resistance
Antimicrobial stewardship
Pneumonia
Sepsis
Ventilator-associated pneumonia
Intensive care unit
Multidrug resistance
Stewardship
Antibiotics
description St James’s Hospital. Department of Anaesthesia and Critical Care Medicine. Dublin, Ireland.
publishDate 2018
dc.date.issued.fl_str_mv 2018
dc.date.accessioned.fl_str_mv 2019-07-16T15:11:53Z
dc.date.available.fl_str_mv 2019-07-16T15:11:53Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.citation.fl_str_mv TISZAI-SZUCS, Tamas et al. Feasibility of antimicrobial stewardship (AMS) in critical care settings: a multidisciplinary approach strategy. Medical Sciences, v. 6, n. 40, p. 1-8, 2018.
dc.identifier.uri.fl_str_mv https://www.arca.fiocruz.br/handle/icict/34155
dc.identifier.issn.pt_BR.fl_str_mv 2076-3271
dc.identifier.doi.pt_BR.fl_str_mv 10.3390/medsci6020040
dc.identifier.eissn.none.fl_str_mv 2076-3271
identifier_str_mv TISZAI-SZUCS, Tamas et al. Feasibility of antimicrobial stewardship (AMS) in critical care settings: a multidisciplinary approach strategy. Medical Sciences, v. 6, n. 40, p. 1-8, 2018.
2076-3271
10.3390/medsci6020040
url https://www.arca.fiocruz.br/handle/icict/34155
dc.language.iso.fl_str_mv eng
language eng
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv MDPI
publisher.none.fl_str_mv MDPI
dc.source.none.fl_str_mv reponame:Repositório Institucional da FIOCRUZ (ARCA)
instname:Fundação Oswaldo Cruz (FIOCRUZ)
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instname_str Fundação Oswaldo Cruz (FIOCRUZ)
instacron_str FIOCRUZ
institution FIOCRUZ
reponame_str Repositório Institucional da FIOCRUZ (ARCA)
collection Repositório Institucional da FIOCRUZ (ARCA)
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