Effectiveness of Electronic Guidelines (GERH®) to Improve the Clinical Use of Antibiotics in an Intensive Care Unit
| Autor: | Manuel Angel Rodriguez-Maresca, Paola Navarro-Gómez, José Gutiérrez-Fernández, Maria del Carmen Olvera-Porcel, Antonio Sorlózano-Puerto |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Microbiology (medical) medicine.medical_specialty medicine.drug_class 030106 microbiology Antibiotics Biochemistry Microbiology intensive care unit Article antibiotics law.invention 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine law Internal medicine medicine Pharmacology (medical) 030212 general & internal medicine General Pharmacology Toxicology and Pharmaceutics computerized clinical decision support system Respiratory tract infections business.industry Teicoplanin lcsh:RM1-950 medicine.disease Intensive care unit Infectious Diseases lcsh:Therapeutics. Pharmacology chemistry Bacteremia Linezolid Vancomycin Daptomycin business medicine.drug |
| Zdroj: | Antibiotics, Vol 9, Iss 521, p 521 (2020) Antibiotics Volume 9 Issue 8 |
| ISSN: | 2079-6382 |
| Popis: | ：The objective of the study was to evaluate the capacity of GERH® derived local resistance maps (LRMs) to predict antibiotic susceptibility profiles and recommend the appropriate empirical treatment for ICU patients with nosocomial infection. Data gathered between 2007 and 2016 were retrospectively studied to compare susceptibility information from antibiograms of microorganisms isolated in blood cultures, lower respiratory tract samples, and urine samples from all ICU patients meeting clinical criteria for infection with the susceptibility mapped by LRMs for these bacterial species. Susceptibility described by LRMs was concordant with in vitro study results in 73.9% of cases. The LRM-predicted outcome agreed with the antibiogram result in > 90% of cases infected with the bacteria for which GERH® offers data on susceptibility to daptomycin, vancomycin, teicoplanin, linezolid, and rifampicin. Full adherence to LRM recommendations would have improved the percentage adequacy of empirical prescriptions by 2.2% for lower respiratory tract infections (p = 0.018), 3.1% for bacteremia (p = 0.07), and 5.3% for urinary tract infections (p = 0.142). LRMs may moderately improve the adequacy of empirical antibiotic therapy, especially for lower respiratory tract infections. LRMs recommend appropriate prescriptions in approximately 50% of cases but are less useful in patients with bacteremia or urinary tract infection. |
| Databáze: | OpenAIRE |
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