Analysis of the use of imipenem at a University Hospital following the restructuring of an antimicrobial audit system

Abstract

This study analyzed the use pattern of imipenem following the restructuring of the antimicrobial audit system at a University Hospital. It was an observational study before and after the restructuring of the antimicrobial audit system in a University Hospital from May to August and then from September to December 2006. The criteria of the rational use of imipenem were obtained from a non-systematic revision of the literature. The collection of data on the general characteristics and clinical state of the patient, the infection and the established therapy was carried out in a previously tested instrument. Data was recorded, revised and analyzed in a database built with the software SPSS® for Windows® PC, version 10.0. The statistical analysis had a descriptive character: frequencies, mean, median and standard deviation. No differences were encountered in relation to the appropriate indication, consumption and clinical outcomes of patients. However, there was a reduction of 4 to 1 (75.0%) in the number of associations with spectrum superposition and an increase of 4 to 8 (50.0%) in the change of therapy. The restructuring of the antimicrobial audit system in the studied hospital did not reflect significantly the increase of the appropriate indication of imipenem. It contributed, however, to the reduction of the inappropriate associations of this antibiotic and to changes of therapy, without, however, compromising the quality of services rendered to patients.

Antibiotic use in Brazilian hospitals in the 21st century: a systematic review

“…Among the studies that analyzed antibiotic consumption using the DDD, we found that according to 5 of the 16 results for antibiotic use (each represented by a column in Tables 3 and 4 since a study may have evaluated the consumption of more than one site or treatment), third-generation cephalosporins were not among the three most used classes of antibiotics. Notably, two of them (2/5) were applied to calculate the consumption of antibiotics prescribed for infections caused by sensitive or resistant Staphylococcus aureus 29 and one for Pseudomonas aeruginosa 36 , while another evaluated only the use of imipenem 41 , and the last one calculated the antibiotic consumption of an entire hospital over four months 39 .…”

“…This review included 23 articles with different methodological designs. The main objective of seven studies was to analyze antibiotic use 20 , 25 , 26 , 28 , 30 , 39 , 42 , while the others presented this data secondary to a main objective, namely: to investigate the relationship between antibiotic consumption and the incidence of resistant bacteria 27 , 35 , 36 , assess indicators of rational drug use in antibiotic prescriptions 34 , assess the adequacy of antibiotic prescriptions by disease or microorganism 31 , 32 , compare antimicrobial therapy with the microorganisms’ sensitivity profile 22 , 26 , 29 , 37 , and assess the impact of implementing interventions in antibiotic consumption 24 , 33 , 40 , 41 .…”