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Impact of Antimicrobial Stewardship Programs in Latin American Adult Intensive Care Units: PROA-LATAM Project

Published online by Cambridge University Press:  02 November 2020

Rodolfo Quirós
Affiliation:
Clínica Ángel Foianini
Patricia Angeleri
Affiliation:
Dirección de Epidemiología-Ministerio de Salud de la Nación, Argentina
Jeannete Zurita
Affiliation:
Hospital Vozandes, Quito-Ecuador
Washington Aleman
Affiliation:
Hospital Alcívar, Guayaquil-Ecuador
Marcelo Carneiro
Affiliation:
UNISC – HSC
Silvia Guerra
Affiliation:
FEPREMI-COCEMI
Julio Medina
Affiliation:
Federación de Prestadores Médicos del Interior (FEPREMI)-Uruguay
Ximena Castañda Luquerna
Affiliation:
Los Cobos Medical Center, Bogotá-Colombia
Alexander Guerra
Affiliation:
Clínica Rey David, Cali-Colombia
Silvio Vega
Affiliation:
Complejo Hospitalario Metropolitano
Luis Cuéllar
Affiliation:
Instituto Nacional de Enfermedades Neopláasica
Jose Munita
Affiliation:
University of Texas at Houston
Gina Maki
Affiliation:
Henry Ford Health System
Tyler Prentiss
Affiliation:
Henry Ford Health System, Detroit-USA
Elvio Escobar
Affiliation:
Clínica Ángel Foianini
Ángel Foianini
Affiliation:
Santa Cruz de la Sierra-Bolivia
Marcus Zervos
Affiliation:
Henry Ford Hospital
Ana Bardossy
Affiliation:
Henry Ford Health System
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Abstract

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Background: Antimicrobial stewardship programs (ASPs) are useful in improving clinical outcomes in a cost-effective way and in reducing antimicrobial resistance. Objective: We sought to determine the impact of ASP in adult medical-surgical intensive care units (MS-ICUs). Methods: A multicenter study, in 77 MS-ICUs of 9 Latin-American countries, was conducted along 12 months (July 2018–June 2019). A self-assessment survey using a tool based on CDC recommendations (0–100 scale) was performed at the beginning, after 6 months, and at the end of the study. The impact of ASP was evaluated monthly using the following indicators: antimicrobial consumption (defined daily doses [DDD] per 100 patient days), appropriateness of antimicrobial prescriptions (percentage of total prescriptions), crude mortality rate (events per 100 discharges), and hospital-acquired multidrug-resistant microorganisms (MDRs) and Clostridioides difficile infections (CDI events per 1,000 patient days). These indicators were compared between MS-ICUs that reached the 75th percentile and those that maintained the 25th percentile at the final self-assessment. Results: Of all indicators evaluated, only surgical prophylaxis ≤24 hours, vancomycin therapeutic monitoring, and aminoglycosides (1 dose per day) did not show significant differences between MS-ICUs at the 75th percentile and the 25th percentile. CDI events were significantly higher at the 75th percentile MS-ICUs, probably related to better detection of C. difficile (Table 1). Conclusions: This study confirmed that MS-ICUs with more comprehensive ASPs had significantly better indicators.

Funding: Proprietary Organization: MERCK

Disclosures: None

Type
Poster Presentations
Copyright
© 2020 by The Society for Healthcare Epidemiology of America. All rights reserved.