Ruiz Ramos J, Suárez-Lledó Grande A, Santolaya Perrín MR, Caballero Requejo C, Hijazi Vega M, López Vinardell M, García Martín A, Campos Baeta Y, Marcos González AJ, Alonso Díez M, Conde Giner S, Herrera Carranza S, Such Diáz A, Prats Riera M, Menendez Liendo L, Toro Blanch C, Revuelta Amallo A, Calzón Blanco C. [Antibiotic stewardship programs in the Spanish emergency services: PROA-URG Study].
Rev Esp Quimioter 2024;
37:163-169. [PMID:
38372121 PMCID:
PMC10945102 DOI:
10.37201/req/138.2023]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 01/07/2024] [Accepted: 02/06/2024] [Indexed: 02/20/2024]
Abstract
OBJECTIVE
Antimicrobial stewardship programs (ASP) have become a key tool in the adaptation of these drugs to the health system. The information available on the application and indicators used in these programs in emergency departments is scarce. The objective of this study is to know the extent of ASP implementation in the emergency departments, as well as the use of antimicrobials in these units.
METHODS
Multicenter retrospective study. An invitation was sent to all participants of the REDFASTER-SEFH emergency pharmacist working group. A questionnaire was used consisting of 21 items, answered by a team made up of a pharmacist, emergency room specialist, infectious disease specialist and microbiologist.
RESULTS
Eighteen hospitals completed the survey. Fourteen (77.8%) had an ASP manager. The DDD value per 1000 admissions ranged between 36.5 and 400.5 (median: 100.4 [IQR:57.2-157.3]). Both carbapenem and macrolide group presented wide variability in use. Six (33.3%) hospitals had an annual report on the specific resistance profile for urine and blood cultures. The percentage of multi-drug resistant strains in urine cultures was 12.5% and in blood cultures 12.2%. The percentage of adequacy in the bacteremia treatment was 81.0% (IQR:74.6-85.0%), while in urinary tract infections was 78.0% (IQR:71.5-88.0).
CONCLUSIONS
Despite the existence of ASP members in emergency services, as well as the training activity and local guidelines is common. knowledge of the use of antimicrobials and resistances is limited. Future activities must be aimed at improving information about the ASP results in these units.
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