Antimicrobial Stewardship: Among Carbapenems, Tigecyline at Department of Medicine
Abstract
Objectives: to study plan changed of carbapenems and tigecycline used from the recommendation by pharmacist, to study of the outcome of treatment and to study cost of antimicrobial used.
Methods: this was retrospective cohort study, all data were collected from medical records and prescription of patients who were admitted at Department of Medicine, Roi Et Hospital and treatment by carbapenems drug group and tigecyline. This study were divide into two groups, group one were patients admitted between May 1, 2016 to July 31 2016 and all of them non- received Antimicrobial Stewardship Program (ASP). Group two, were patients after received ASP and admitted during October 1, 2016 to December 31, 2016. The data analysis were used descriptive and Chi-square Test.
Results: The total numbers of subjects before ASP were 178 cases, most of them were male 70.22 %, mean age 63.1 years, principle diagnosis was infectious diseases 44.94 %, discharge by improve 60.01%, not improve/dead 39.89 % and the total cost of carbapenems and tigecycline to treatment all of patients in the hospital at the time of study were 5,370,383.50 Bath. The total numbers of study subjects after ASP were 89 cases, most of them were male 61.80, mean age 61.64 years, principle diagnosis was infectious diseases 43.92 %, discharge by improve 60.07%, not improve/dead 39.33 % and the total cost of carbapenems and tigecycline to treatment all of patients in the hospital at the time of study were 4,306,696.50 Bath. After receives ASP were changed the plan to treatment followed the recommendation of pharmacist 90.01%.
Conclusion: The outcomes of ASP were patients received appropriate treatment, the treatment not different from standard and the cost of carbapenems and tigecycline were decreases.
Keywords: Antimicrobial; Antimicrobial Stewardship Program; Pharmacist; Department of Medicine
References
Lizioli A, Privitera G, Alliata E, Antonietta Banfi EM, Boselli L, Panceri ML, et al. Prevalence of nosocomial infections in Italy: result from the Lombardy survey in 2000. J Hosp Infect 2003 ;54:141–8.
Danchaivijitrmd S, Dhiraputra C, Santiprasitkul S, Judaeng T. Prevalence and impacts of nosocomial infection in Thailand 2001. J Med Assoc Thail Chotmaihet Thangphaet 2005;88:S1-9.
Danchaivijitr S, Dhiraputra C, Santiprasitkul S, Judaeng T. Prevalence and impacts of nosocomial infection in Thailand 2001. J Med Assoc Thai 2005;88:S1–9.
Danchaivijitr S, Judaeng T, Sripalakij S, Naksawas K, Plipat T. Prevalence of nosocomial infection in Thailand 2006. J-Med Assoc Thai 2007;90:1524.
Rosenthal VD, Bijie H, Maki DG, Mehta Y, Apisarnthanarak A, Medeiros EA, et al. International Nosocomial Infection Control Consortium (INICC) report, data summary of 36 countries, for 2004-2009. Am J Infect Control 2012 ;40:396–407.
Rosenthal VD, Al-Abdely HM, El-Kholy AA, AlKhawaja SAA, Leblebicioglu H, Mehta Y, et al. International Nosocomial Infection Control Consortium report, data summary of 50 countries for 2010-2015: Device-associated module. Am J Infect Control 2016 1;44:1495–504.
Petdachai W. Ventilator-associated pneumonia in a newborn intensive care unit. Southeast Asian J Trop Med Public Health 2004;35:724–9.
Bayani M, Siadati S, Rajabnia R, Taher AA. Drug Resistance of Pseudomonas aeruginosa and Enterobacter cloacae Isolated from ICU, Babol, Northern Iran. Int J Mol Cell Med 2013;2:204–9.
Gurung J, Khyriem AB, Banik A, Lyngdoh WV, Choudhury B, Bhattacharyya P. Association of biofilm production with multidrug resistance among clinical isolates of Acinetobacter baumannii and Pseudomonas aeruginosa from intensive care unit. Indian J Crit Care Med Peer-Rev Off Publ Indian Soc Crit Care Med 2013;17(4):214–8.
Rhodes D, Cheng AC, McLellan S, Guerra P, Karanfilovska D, Aitchison S, et al. Reducing Staphylococcus aureus bloodstream infections associated with peripheral intravenous cannulae: successful implementation of a care bundle at a large Australian health service. J Hosp Infect 2016 7; 12-20
Nuvials X, Palomar M, Alvarez-Lerma F, Olaechea P, Otero S, Uriona S, et al. Primary bacteriemia and catheter related bloodstream infection in patients admitted to ICU. risk factors associated with mortality. ENVIN-HELICS registry data. Intensive Care Med Exp 2015;3:A889.
Sader HS, Castanheira M, Flamm RK, Mendes RE, Farrell DJ, Jones RN. Ceftazidime/avibactam tested against Gram-negative bacteria from intensive care unit (ICU) and non-ICU patients, including those with ventilator-associated pneumonia. Int J Antimicrob Agents 2015;46:53–9.
Tumbarello M, De Pascale G, Trecarichi EM, Spanu T, Antonicelli F, Maviglia R, et al. Clinical outcomes of Pseudomonas aeruginosa pneumonia in intensive care unit patients. Intensive Care Med 2013 ;39:682–92.
Espinar MJ, Miranda IM, Costa-de-Oliveira S, Rocha R, Rodrigues AG, Pina-Vaz C. Urinary Tract Infections in Kidney Transplant Patients Due to Escherichia coli and Klebsiella pneumoniae-Producing Extended-Spectrum β-Lactamases: Risk Factors and Molecular Epidemiology. PloS One 2015;10:e0134737.
Nakai H, Hagihara M, Kato H, Hirai J, Nishiyama N, Koizumi Y, et al. Prevalence and risk factors of infections caused by extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae. J Infect Chemother Off J Jpn Soc Chemother 2016 ;22:319–26.
Chopra T, Marchaim D, Johnson PC, Chalana IK, Tamam Z, Mohammed M, et al. Risk factors for bloodstream infection caused by extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella pneumoniae: A focus on antimicrobials including cefepime. Am J Infect Control 2015 ;43:719–23.
Søraas A, Sundsfjord A, Sandven I, Brunborg C, Jenum PA. Risk factors for community-acquired urinary tract infections caused by ESBL-producing enterobacteriaceae--a case-control study in a low prevalence country. PloS One 2013;8:e69581.
Superti SV, Augusti G, Zavascki AP. Risk factors for and mortality of extended-spectrum-beta-lactamase-producing Klebsiella pneumoniae and Escherichia coli nosocomial bloodstream infections. Rev Inst Med Trop Sao Paulo 2009;51:211–6.
Mosqueda-Gómez JL, Montaño-Loza A, Rolón AL, Cervantes C, Bobadilla-del-Valle JM, Silva-Sánchez J, et al. Molecular epidemiology and risk factors of bloodstream infections caused by extended-spectrum beta-lactamase-producing Klebsiella pneumoniae A case-control study. Int J Infect Dis IJID Off Publ Int Soc Infect Dis 2008;12:653–9.
อนันต์วัฒนกิจมรกต, อุษยาพรแสง, ตัณฑวิเชียรธีระพงษ์, พุฒิเลอพงศ์ชาญกิจ, เพ็งสุภาพธิติมา, Ananwattanakit M, et al. ผลของการมีเภสัชกรร่วมในโปรแกรมการเปลี่ยนแปลงและชี้นำการใช้ยาต้านจุลชีพต่อความเหมาะสมในการสั่งใช้ยาต้าน จุลชีพ Effects of Pharmacist Participation in an Antimicrobial Stewardship Program on Appropriate Antibiotic Use. Thai Pharm Health Sci J - วารสารไทยเภสัชศาสตร์และวิทยาการสุขภาพ 2015;10:1–9.
Bessesen MT, Ma A, Clegg D, Fugit RV, Pepe A, Goetz MB, et al. Antimicrobial Stewardship Programs: Comparison of a Program with Infectious Diseases Pharmacist Support to a Program with a Geographic Pharmacist Staffing Model. Hosp Pharm 2015 ;50:477–83.
Bartlett JM, Siola PL. Implementation and first-year results of an antimicrobial stewardship program at a community hospital. Am J Health-Syst Pharm AJHP Off J Am Soc Health-Syst Pharm 2014 1;71:943–9.
Waters CD. Pharmacist-driven antimicrobial stewardship program in an institution without infectious diseases physician support. Am J Health-Syst Pharm AJHP Off J Am Soc Health-Syst Pharm 2015;72:466–8.
Okumura LM, Riveros BS, Gomes-da-Silva MM, Veroneze I. A cost-effectiveness analysis of two different antimicrobial stewardship programs. Braz J Infect Dis Off Publ Braz Soc Infect Dis 2016 ;20:255–61.
Okumura LM, Silva MMG da, Veroneze I. Effects of a bundled Antimicrobial Stewardship Program on mortality: a cohort study. Braz J Infect Dis Off Publ Braz Soc Infect Dis 2015;19:246–52.
Perez KK, Olsen RJ, Musick WL, Cernoch PL, Davis JR, Peterson LE, et al. Integrating rapid diagnostics and antimicrobial stewardship improves outcomes in patients with antibiotic-resistant Gram-negative bacteremia. J Infect 2014;69:216–25.
Downloads
Published
How to Cite
Issue
Section
License
วารสารนี้เป็นลิขสิทธิ์ของโรงพยาบาลมหาสารคาม
