Reduction of antimicrobial treatment time in intensive care units in Fortaleza, Brazil

Angelina Almeida Bastos; Elana Figueiredo Chaves; Maria Luiza Almeida Bastos; Bruna Suellen Pereira; Márcio de Souza Cavalcante; Henry Pablo  Lopes Campos e Reis; José Martins de Alcântara Neto; Cinthya Cavalcante de Andrade

doi:10.30827/ars.v64i3.27830

Autores/as

Angelina Almeida Bastos Federal University of Ceará, Walter Cantídio University Hospital, Multiprofessional Integrated Residency Program in Hospital Health Care, Fortaleza, Brazil. https://orcid.org/0000-0002-8908-7186
Elana Figueiredo Chaves Hospital Universitário Walter Cantídio https://orcid.org/0000-0002-5817-0999
Maria Luiza Almeida Bastos Federal University of Ceará, Faculty of Medicine, Community Health Department, Fortaleza, Brazil. https://orcid.org/0000-0003-2427-5896
Bruna Suellen Pereira Federal University of Ceará, Walter Cantídio University Hospital, Multiprofessional Integrated Residency Program in Hospital Health Care, Fortaleza, Brazil.
Márcio de Souza Cavalcante Federal University of Ceará, Walter Cantídio University Hospital, hospital pharmacy service, Fortaleza, Brazil. https://orcid.org/0000-0003-1045-7912
Henry Pablo Lopes Campos e Reis Federal University of Ceará, Walter Cantídio University Hospital, hospital pharmacy service, Fortaleza, Brazil.
José Martins de Alcântara Neto Federal University of Ceará, Walter Cantídio University Hospital, hospital pharmacy service, Fortaleza, Brazil.
Cinthya Cavalcante de Andrade Federal University of Ceará, Walter Cantídio University Hospital, hospital pharmacy service, Fortaleza, Brazil.

DOI:

https://doi.org/10.30827/ars.v64i3.27830

Palabras clave:

Antibacterianos, Programas de Optimización del Uso de los Antimicrobianos, Cuidados Críticos, Utilización de Medicamentos

Resumen

Objetivo: Evaluar la aplicación de la estrategia reducción del tiempo de tratamiento Antimicrobiano (ATM) en Unidades de Cuidados Intensivos (UCI) en un Programa Stewardship de Antimicrobiano (ASP).

Método: Este es un estudio descriptivo y transversal, realizado en dos UCI de un hospital universitario de Fortaleza, Brasil, de enero/2017 a enero/2019. Se incluyeron pacientes adultos, acompañados por un farmacéutico y utilizando ATM, en los que se aplicó la estrategia de reducción del tiempo de tratamiento. La evaluación de la estrategia se realizó a través de la diferencia entre el tiempo previsto establecido al inicio del tratamiento y los días efectivos de uso de cada ATM.

Resultados: De los 100 pacientes incluidos, 51,0 % eran del sexo masculino y 64,0 % ancianos. El sistema respiratorio fue el más frecuentemente afectado (37,4 %) y las clases de ATM más prevalentes fueron los carbapenémicos (23,0 %) y los glicopéptidos (20,1 %). Hubo una disminución de 831 días innecesarios de terapia antimicrobiana y de un promedio de 13,7 a 8,9 días de tratamiento. Las mayores reducciones en días se observaron para meropenem, con 202 días reducidos. El estudio también permitió identificar asociaciones entre la reducción > 8 días de tratamiento y las variables estancia > 22 días y pacientes en cuidados paliativos exclusivos; y asociaciones entre alta hospitalaria y reducciones de hasta 7 días de terapia.

Conclusiones: Los datos obtenidos sugieren que la presencia de un ASP influye en las prácticas de uso de ATM y su tiempo de tratamiento y enfatizan el papel de los profesionales farmacéuticos en estos programas.

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