دورية أكاديمية
أعرض في EDS

Antimicrobial stewardship programme associated with earlier prescription of in vitro susceptible therapy and lower 14-day mortality in patients with carbapenem-resistant Enterobacterales bacteraemia: a cohort study.

التفاصيل البيبلوغرافية
العنوان: Antimicrobial stewardship programme associated with earlier prescription of in vitro susceptible therapy and lower 14-day mortality in patients with carbapenem-resistant Enterobacterales bacteraemia: a cohort study.
المؤلفون: Barros A; Medical Sciences Postgraduate Program, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Infection Control Service, Hospital São Lucas da PUCRS, Porto Alegre, RS, Brazil., Monroy H; Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) Medical School, Porto Alegre, RS, Brazil., Bergo P; Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) Medical School, Porto Alegre, RS, Brazil., Beck E; Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) Medical School, Porto Alegre, RS, Brazil., David L; Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) Medical School, Porto Alegre, RS, Brazil., Rigatto MH; Medical Sciences Postgraduate Program, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) Medical School, Porto Alegre, RS, Brazil; Infectious Disease Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil; Young Medical Leadership Program of the National Academy of Medicine in Brazil. Electronic address: mhprigatto@gmail.com.
المصدر: Journal of global antimicrobial resistance [J Glob Antimicrob Resist] 2022 Mar; Vol. 28, pp. 130-135. Date of Electronic Publication: 2021 Dec 18.
نوع المنشور: Journal Article; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: Published by Elsevier Ltd. on behalf of International Society of Chemotherapy for Infection and Cancer Country of Publication: Netherlands NLM ID: 101622459 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2213-7173 (Electronic) Linking ISSN: 22137165 NLM ISO Abbreviation: J Glob Antimicrob Resist Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Amsterdam : Published by Elsevier Ltd. on behalf of International Society of Chemotherapy for Infection and Cancer
مواضيع طبية MeSH: Antimicrobial Stewardship* , Bacteremia*/microbiology , Drug Resistance, Bacterial* , Gammaproteobacteria* , Shock, Septic*/drug therapy, Anti-Bacterial Agents/therapeutic use ; Carbapenems/therapeutic use ; Cohort Studies ; Humans ; Prescriptions ; Retrospective Studies
مستخلص: Objectives: This study analysed the impact of antimicrobial stewardship team (AST) evaluation on time to susceptible in vitro therapy and mortality of patients with carbapenem-resistant Enterobacterales (CRE) bacteraemia.
Methods: We performed a retrospective cohort study (February 2018 to July 2020) to evaluate the impact of AST evaluation, along with other clinical and microbiological variables, on time to appropriate antibiotics, 14-day mortality and in-hospital mortality in patients aged >18 years with CRE bacteraemia. A Cox regression model was used for multivariate analysis.
Results: A total of 142 patients were included. The proportion of patients who received appropriate antibiotics in the first 5 days after bacteraemia was 82/92 (89.1%) versus 29/50 (58.0%) evaluated and not evaluated by the AST, respectively (P < 0.01). AST evaluation reduced the median time to appropriate therapy (49.8 h vs. 71.1 h; P = 0.01). AST intervention was independently associated with earlier prescription of appropriate therapy (P = 0.02) when controlled for septic shock (P < 0.01) and CRE isolation in the previous 90 days (P = 0.04). Regarding mortality, 51 patients (35.9%) died within 14 days (25.8% vs. 44.7% with and without AST intervention, respectively; P = 0.02) and 82 patients (57.7%) in hospital (52.2% vs. 68.0% evaluated and not evaluated by the AST, respectively; P = 0.08). AST intervention was independently protective for 14-day mortality (P = 0.03) when controlled for septic shock status (P < 0.01).
Conclusion: AST guidance improves the quality of antibiotic prescriptions and clinical outcomes in patients with CRE bacteraemia.
(Copyright © 2021. Published by Elsevier Ltd.)
فهرسة مساهمة: Keywords: Antimicrobial stewardship; CRE; Carbapenem-resistant Enterobacterales; Mortality
المشرفين على المادة: 0 (Anti-Bacterial Agents)
0 (Carbapenems)
تواريخ الأحداث: Date Created: 20211221 Date Completed: 20220505 Latest Revision: 20220531
رمز التحديث: 20231215
DOI: 10.1016/j.jgar.2021.12.011
PMID: 34933141
قاعدة البيانات: MEDLINE
الوصف
تدمد:2213-7173
DOI:10.1016/j.jgar.2021.12.011