Agreement on the prescription of antimicrobial drugs.

Autor: Casaroto E; Intensive Care Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil. eduardo.casaroto@einstein.br., Marra AR; Division of Medical Practice, Hospital Israelita Albert Einstein, Av. Albert Einstein, 627/701 - 1st floor - Bloco A1 - Room 108 Morumbi, 05651-901, São Paulo, Brazil. alexandre.marra@einstein.br., Camargo TZ; Intensive Care Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil. thiago.zinsly@einstein.br., de Souza AR; Intensive Care Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil. ana.souza@einstein.br., de Almeida CE; Intensive Care Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil. carlos.almeida@einstein.br., Pedroti EP; Intensive Care Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil. elizia.pedroti@einstein.br., Victor Eda S; Instituto Israelita de Ensino e Pesquisa Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, Brazil. elivane.victor@einstein.br., dos Santos OF; Division of Medical Practice, Hospital Israelita Albert Einstein, Av. Albert Einstein, 627/701 - 1st floor - Bloco A1 - Room 108 Morumbi, 05651-901, São Paulo, Brazil. oscar@einstein.br., Edmond MB; Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA. michael-edmond@uiowa.edu., Campos AH; Instituto Israelita de Ensino e Pesquisa Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, Brazil. alexandre.campos@einstein.br.
Jazyk: angličtina
Zdroj: BMC infectious diseases [BMC Infect Dis] 2015 Jun 30; Vol. 15, pp. 248. Date of Electronic Publication: 2015 Jun 30.
DOI: 10.1186/s12879-015-0992-y
Abstrakt: Background: There is universal awareness of the difficulties faced by doctors when prescribing antimicrobials.
Methods: Over a six-month period patients hospitalized in the ICU and under treatment with antibiotics and/or antifungals were eligible to participate in the study. The data were assessed by two infectious diseases specialists. Once completed, all case forms were sent independently to both evaluators (TZSC and ARM) by e-mail. Based on the data received, the evaluator completed a form automatically generated on the e-mail and returned it to the original mailbox for further analysis. We assessed the level of agreement between infectious disease specialists and the physicians directly responsible for the decision to begin antimicrobial therapy, as well as to assess the appropriateness of the regimen prescribed.
Results: Among the antimicrobial regimens prescribed to the 177 patients, 36% were considered inappropriate by specialist #1 and 38% were considered inappropriate by specialist #2. We found 78% agreement by at least one of the infectious disease specialists with the prescribed antimicrobial regimen, and in 49% of cases both specialists agreed with the prescribed regimen. Both disagreed with the prescribed regimen in 22% of the cases and they disagreed between themselves in 29% of the cases.
Conclusion: This study highlights the difficulties in prescribing effective empirical antimicrobial therapy--they are of such magnitude that even two specialists in infectious diseases, well acquainted with our hospital's resistance patterns and our patients' profiles have considerable disagreement.
Databáze: MEDLINE
Externí odkaz: