Conversion of intravenous to oral antibiotic therapy in an adult intensive care unit

Abstract

Objective: To identify the possibility of alteration of intravenous (IV) to oral (PO) therapy for ampicillin/sulbactam and cefuroxime in adult patients treated in intensive care units (ICUs), and to describe the profile and consumption of antimicrobials prescribed for these patients. Methods: A descriptive, cross-sectional, and retrospective documentary study based on the analysis of electronic prescriptions and data from the electronic medical record of patients admitted to adult intensive care units in two hospitals, from July to August 2019. The consumption of antimicrobials was measured using the Anatomical Therapeutic Chemical/Daily Defined Dose (ATC/DDD) methodology per 100 beds-day. Results: Of the patients admitted to the study units, 23 (5.5%) received ampicillin/sulbactam or cefuroxime; the time of the ampicillin/sulbactam treatment was 7.25 (±2.07) days and, with cefuroxime, 8 (±1.73) days; 3 (13%) of the patients followed were eligible to switch therapy or sequential therapy, there was no physician acceptance of the conversion recommendation. The highest consumption was observed in the penicillins therapeutic group (112.5 DDD/100 beds-day) and meropenem drug (68.8 DDD/100 beds-day). Conclusions: Antimicrobial use is high in ICUs, which can be related to the clinical complexity and to the microbiological profile of the patients. The practice of converting IV antibiotic therapy to PO in critically ill patients was not present in this study; however, its use can contribute to patient safety.

Mapeamento de problemas relacionados a medicamentos envolvendo a prescrição de fármacos opioides em um hospital universitário de Curitiba

“…analgesic drugs from the intravenous to the oral route through the evaluation of treatment duration and pharmacokinetics, respecting the potency class and level and resulting in lower therapy costs [22][23][24][25] .…”

O papel da assistência farmacêutica na oncologia pediátrica

“…Perpassando desde a validação das prescrições médicas (quanto a dose, interação, compatibilidade e esquemas de tratamento), higienização das bolsas de soro (lavagem manual com solução de clorexidina e logo após álcool a 70%), preparo dos medicamentos, preenchimento e impressão dos rótulos (Sehn et al, 2003;Silva et al, 2020). Dessa forma, é inegável a dimensão que o farmacêutico possui em pacientes oncológicos no que diz respeito às interações medicamentosas, que podem favorecer em insucesso terapêutico e o agravamento da condição de saúde do paciente (Scrignoli et al, 2019).…”

Switch therapy da associação de ampicilina e sulbactam em complexo hospitalar do sul do Brasil

“…The general pediatric hospital was excluded, due to the patients' difficulty in swallowing. In addition to that, the ICUs were also excluded since, in the study by Locatelli et al (2020), carried out in the same hospital complex, there was a low percentage of patients eligible to switch from intravenous to oral antimicrobials, due to the severity of their clinical condition. 17 The patients were categorized as "eligible" or "non-eligible" to change the treatment administration route by the Clinical Pharmacy service, according to parameters agreed upon with the SCIH.…”

“…In addition to that, the ICUs were also excluded since, in the study by Locatelli et al (2020), carried out in the same hospital complex, there was a low percentage of patients eligible to switch from intravenous to oral antimicrobials, due to the severity of their clinical condition. 17 The patients were categorized as "eligible" or "non-eligible" to change the treatment administration route by the Clinical Pharmacy service, according to parameters agreed upon with the SCIH. Patients who presented good oral acceptance of the diet, axillary temperature below 38°C and absence of vomiting in the last 24 hours were considered eligible.…”