Antibiotic Consumption and Deviation of Prescribed Daily Dose From the Defined Daily Dose in Critical Care Patients: A Point-Prevalence Study

Detalhes bibliográficos
Autor(a) principal: Nunes, Patricia Helena Castro
Data de Publicação: 2022
Outros Autores: Moreira, Jessica Pronestino de Lima, Thompson, Alessandra de Figueiredo, Machado, Thalita Lyrio da Silveira, Cerbino-Neto, José, Bozza, Fernando Augusto
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da FIOCRUZ (ARCA)
Texto Completo: https://www.arca.fiocruz.br/handle/icict/55530
Resumo: Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil / D'Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil.
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spelling Nunes, Patricia Helena CastroMoreira, Jessica Pronestino de LimaThompson, Alessandra de FigueiredoMachado, Thalita Lyrio da SilveiraCerbino-Neto, JoséBozza, Fernando Augusto2022-11-08T11:42:12Z2022-11-08T11:42:12Z2022NUNES, Patricia Helena Castro et al. Antibiotic Consumption and Deviation of Prescribed Daily Dose From the Defined Daily Dose in Critical Care Patients: A Point-Prevalence Study. Frontiers in Pharmacology, v. 13, p. 1-9, 2022.1663-9812https://www.arca.fiocruz.br/handle/icict/5553010.3389/fphar.2022.913568engFrontiers MediaAntibiotic Consumption and Deviation of Prescribed Daily Dose From the Defined Daily Dose in Critical Care Patients: A Point-Prevalence Studyinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleFundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil / D'Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil.D'Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil / Fluminense Federal University. Faculty of Pharmacy. Niterói, RJ, Brazil.D'Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil / Copa D'Or Hospital. Rio de Janeiro, RJ, Brazil.D'Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil / Copa D'Or Hospital. Rio de Janeiro, RJ, Brazil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil / D'Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil / D'Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil.Background: The consumption of antibiotics is one of the metrics used to evaluate the impact of antimicrobial stewardship programs (ASP). The aim of this study was to determine the prevalence of antibiotic consumption in Brazilian intensive care units (ICUs) and estimate the deviation of the prescribed daily dose (PDD) from the defined daily dose (DDD). Methods: This is a multicenter, observational, point-prevalence study carried out in adult ICUs of 8 Brazilian hospitals from August 2019, to February 2020. We collected data on the patient's demographic and clinical characteristics, antibiotic therapy, classification and site of infections. The DU90 (antibiotic accounting for 90% of the volume utilized) was calculated, and the antibiotics were classified by the Anatomical Therapeutic Chemical (ATC) Index and the World Health Organization (WHO) Access, Watch, Reserve (AWaRe) groups. For the most prevalent antibiotics, the deviation of PDD from DDD was determined. Results: Three hundred thirty-two patients from 35 ICUs were analyzed. The prevalence of antibiotic use was 52.4%. The patients in use of antibiotics were predominantly over 60 years of age (81.6%) with pulmonary infections (45.8%). A predominance of empirical regimens was observed (62.6%) among antibiotic therapies. The highest frequencies of prescriptions observed were for piperacillin + tazobactam (16.1%), meropenem (13.3%), amoxicillin + clavulanate (7.2%), azithromycin (7.2%), and teicoplanin (6.1%). The watch (64.2%) and reserve (9.6%) categories of the AWaRe classification accounted for 73.8% of all antibiotics, and they were prescribed alone or in combinations. High variability of doses was observed for the most prescribed antibiotics, and large deviations of PDD from the DDD were observed for meropenem, teicoplanin, and tigecycline. Conclusions: The high prevalence of antibiotic prescription was related to a predominance of empirical regimens and antibiotics belonging to the WHO Watch classification. High variability of doses and large deviations of PDD from DDD for meropenem, teicoplanin, and tigecycline was observed, suggesting that DDD may be insufficient to monitor the consumption of these antibiotics in the ICU population. The variability of doses found for the most prescribed antibiotics suggests the need for monitoring and intervention targets for antibiotic stewardship teams.Anti-bacterial agentsAntibioticConsumptionDefined daily doseDrug utilizationIntensive care unitPrescribed daily doseinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txtlicense.txttext/plain; charset=utf-82991https://www.arca.fiocruz.br/bitstream/icict/55530/1/license.txt5a560609d32a3863062d77ff32785d58MD51ORIGINALAntibiotic_Patricia_Nunes_etal_INI_2022.pdfAntibiotic_Patricia_Nunes_etal_INI_2022.pdfapplication/pdf658136https://www.arca.fiocruz.br/bitstream/icict/55530/2/Antibiotic_Patricia_Nunes_etal_INI_2022.pdf85cab1401a5318e9be2dce29654f3fb7MD52icict/555302022-12-02 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dc.title.en_US.fl_str_mv Antibiotic Consumption and Deviation of Prescribed Daily Dose From the Defined Daily Dose in Critical Care Patients: A Point-Prevalence Study
title Antibiotic Consumption and Deviation of Prescribed Daily Dose From the Defined Daily Dose in Critical Care Patients: A Point-Prevalence Study
spellingShingle Antibiotic Consumption and Deviation of Prescribed Daily Dose From the Defined Daily Dose in Critical Care Patients: A Point-Prevalence Study
Nunes, Patricia Helena Castro
Anti-bacterial agents
Antibiotic
Consumption
Defined daily dose
Drug utilization
Intensive care unit
Prescribed daily dose
title_short Antibiotic Consumption and Deviation of Prescribed Daily Dose From the Defined Daily Dose in Critical Care Patients: A Point-Prevalence Study
title_full Antibiotic Consumption and Deviation of Prescribed Daily Dose From the Defined Daily Dose in Critical Care Patients: A Point-Prevalence Study
title_fullStr Antibiotic Consumption and Deviation of Prescribed Daily Dose From the Defined Daily Dose in Critical Care Patients: A Point-Prevalence Study
title_full_unstemmed Antibiotic Consumption and Deviation of Prescribed Daily Dose From the Defined Daily Dose in Critical Care Patients: A Point-Prevalence Study
title_sort Antibiotic Consumption and Deviation of Prescribed Daily Dose From the Defined Daily Dose in Critical Care Patients: A Point-Prevalence Study
author Nunes, Patricia Helena Castro
author_facet Nunes, Patricia Helena Castro
Moreira, Jessica Pronestino de Lima
Thompson, Alessandra de Figueiredo
Machado, Thalita Lyrio da Silveira
Cerbino-Neto, José
Bozza, Fernando Augusto
author_role author
author2 Moreira, Jessica Pronestino de Lima
Thompson, Alessandra de Figueiredo
Machado, Thalita Lyrio da Silveira
Cerbino-Neto, José
Bozza, Fernando Augusto
author2_role author
author
author
author
author
dc.contributor.author.fl_str_mv Nunes, Patricia Helena Castro
Moreira, Jessica Pronestino de Lima
Thompson, Alessandra de Figueiredo
Machado, Thalita Lyrio da Silveira
Cerbino-Neto, José
Bozza, Fernando Augusto
dc.subject.en.en_US.fl_str_mv Anti-bacterial agents
Antibiotic
Consumption
Defined daily dose
Drug utilization
Intensive care unit
Prescribed daily dose
topic Anti-bacterial agents
Antibiotic
Consumption
Defined daily dose
Drug utilization
Intensive care unit
Prescribed daily dose
description Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil / D'Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil.
publishDate 2022
dc.date.accessioned.fl_str_mv 2022-11-08T11:42:12Z
dc.date.available.fl_str_mv 2022-11-08T11:42:12Z
dc.date.issued.fl_str_mv 2022
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 NUNES, Patricia Helena Castro et al. Antibiotic Consumption and Deviation of Prescribed Daily Dose From the Defined Daily Dose in Critical Care Patients: A Point-Prevalence Study. Frontiers in Pharmacology, v. 13, p. 1-9, 2022.
dc.identifier.uri.fl_str_mv https://www.arca.fiocruz.br/handle/icict/55530
dc.identifier.issn.en_US.fl_str_mv 1663-9812
dc.identifier.doi.none.fl_str_mv 10.3389/fphar.2022.913568
identifier_str_mv NUNES, Patricia Helena Castro et al. Antibiotic Consumption and Deviation of Prescribed Daily Dose From the Defined Daily Dose in Critical Care Patients: A Point-Prevalence Study. Frontiers in Pharmacology, v. 13, p. 1-9, 2022.
1663-9812
10.3389/fphar.2022.913568
url https://www.arca.fiocruz.br/handle/icict/55530
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 Frontiers Media
publisher.none.fl_str_mv Frontiers Media
dc.source.none.fl_str_mv reponame:Repositório Institucional da FIOCRUZ (ARCA)
instname:Fundação Oswaldo Cruz (FIOCRUZ)
instacron:FIOCRUZ
instname_str Fundação Oswaldo Cruz (FIOCRUZ)
instacron_str FIOCRUZ
institution FIOCRUZ
reponame_str Repositório Institucional da FIOCRUZ (ARCA)
collection Repositório Institucional da FIOCRUZ (ARCA)
bitstream.url.fl_str_mv https://www.arca.fiocruz.br/bitstream/icict/55530/1/license.txt
https://www.arca.fiocruz.br/bitstream/icict/55530/2/Antibiotic_Patricia_Nunes_etal_INI_2022.pdf
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repository.name.fl_str_mv Repositório Institucional da FIOCRUZ (ARCA) - Fundação Oswaldo Cruz (FIOCRUZ)
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