Antibiotic Use in Medical-Surgical Intensive Care Units and General Wards in Latin American Hospitals.
| Title: | Antibiotic Use in Medical-Surgical Intensive Care Units and General Wards in Latin American Hospitals. |
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| Authors: | Fabre V; Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.; Cosgrove SE; Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.; Lessa FC; International Infection Control Branch, Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.; Patel TS; International Infection Control Branch, Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.; Aleman WR; Hospital Alcivar, Guayaquil, Ecuador.; Aquiles B; Hospital Sociedad de Lucha Contra el Cáncer, Guayaquil, Ecuador.; Arauz AB; Departamento de Medicina, Universidad de Panamá, Panama, Panama.; Hospital Santo Tomas, Panama, Panama.; Barberis MF; Hospital Nacional Profesor Alejandro Posadas, El Palomar, Argentina.; Bangher MDC; Instituto de Cardiología de Corrientes 'Juana Francisca Cabral,' Corrientes, Argentina.; Bernachea MP; Clínica Conciencia, Neuquén, Argentina.; Bernan ML; Hospital Interzonal General de Agudos San Roque, Buenos Aires, Argentina.; Blanco I; Pacifica Salud, Hospital Punta Pacifica, Panamá, Panama.; Cachafeiro A; Pacifica Salud, Hospital Punta Pacifica, Panamá, Panama.; Castañeda X; Clínica De La Mujer, Bogotá, Colombia.; Hospital Mederi, Bogota, Colombia.; Castillo S; Hospital Del Tunal, Bogotá, Colombia.; Colque AM; Hospital Medico Policial Churruca Visca, Buenos Aires, Argentina.; Contreras R; Hospital Dr. Marcial V. Quiroga, San Juan, Argentina.; Cornistein W; Hospital Universitario Austral, Buenos Aires, Argentina.; Correa SM; Hospital Municipal de Trauma Dr. Federico Abete, Malvinas Argentinas, Argentina.; Correal Tovar PC; Hospital Clínica Medicentro Familiar, Bogota, Colombia.; Costilla Campero G; Hospital Angel C. Padilla, Tucumán, Argentina.; Esquivel C; Hospital San Benito, Peten, Guatemala.; Ezcurra C; Hospital Alemán, Buenos Aires, Argentina.; Falleroni LA; Hospital Provincial de Rosario, Rosario, Argentina.; Fernandez J; Hospital Dr. Guillermo Rawson, San Juan, Argentina.; Ferrari S; Hospital Dr. Guillermo Rawson, San Juan, Argentina.; Frassone N; Clínica Universitaria Privada Reina Fabiola, Córdoba, Argentina.; Garcia Cruz C; Hospital Sociedad de Lucha Contra el Cáncer, Guayaquil, Ecuador.; Garzón MI; Hospital Privado Universitario de Córdoba, Córdoba, Argentina.; Gomez Quintero CH; Clínica De La Mujer, Bogotá, Colombia.; Hospital Militar Central, Bogotá, Colombia.; Gonzalez JA; Hospital Irma de Lourdes Tzanetatos, Panama, Panama.; Guaymas L; Clinica Privada Provincial, Buenos Aires, Argentina.; Guerrero-Toapanta F; Hospital Carlos Andrade Marín, Quito, Ecuador.; Lambert S; Hospital El Cruce, Buenos Aires, Argentina.; Laplume D; Hospital Nacional Profesor Alejandro Posadas, El Palomar, Argentina.; Lazarte PR; Maternidad Nuestra Señora De Las Mercedes De Tucumán, Tucumán, Argentina.; Lemir CG; Hospital San Bernardo, Salta, Argentina.; Lopez A; Hospital Alcivar, Guayaquil, Ecuador.; Lopez IL; Clinica Hospital San Fernando, Panama, Panama.; Martinez G; Hospital San Bernardo, Salta, Argentina.; Maurizi DM; Hospital Municipal de Agudos Dr. Leonidas Lucero, Bahía Blanca, Argentina.; Melgar M; Hospital Roosevelt, Guatemala, Guatemala.; Mesplet F; Hospital Cesar Milstein, Buenos Aires, Argentina.; Morales Pertuz C; Hospital Del Tunal, Bogotá, Colombia.; Moreno C; Hospital Metropolitano, Quito, Ecuador.; Moya LG; Clínica Conciencia, Neuquén, Argentina.; Nuccetelli Y; Instituto de Diagnostico, La Plata, Argentina.; Núñez G; Hospital Santo Tomas, Panama, Panama.; Paez H; Hospital Simon Bolivar, Bogota, Colombia.; Palacio B; Sanatorio Allende Nueva Córdoba, Córdoba, Argentina.; Pellice F; Hospital Dr. Marcial V. Quiroga, San Juan, Argentina.; Pereyra ML; Hospital Universitario Austral, Buenos Aires, Argentina.; Pirra LS; Hospital Privado Universitario de Córdoba, Córdoba, Argentina.; Raffo CL; Hospital Municipal de Trauma Dr. Federico Abete, Malvinas Argentinas, Argentina.; Reino Choto F; Hospital Carlos Andrade Marín, Quito, Ecuador.; Vence Reyes L; The Panama Clinic, Panama, Panama.; Ricoy G; Hospital Medico Policial Churruca Visca, Buenos Aires, Argentina.; Rodriguez Gonzalez P; Hospital Clínica Medicentro Familiar, Bogota, Colombia.; Rodriguez V; Hospital Alemán, Buenos Aires, Argentina.; Romero F; Sanatorio Allende Nueva Córdoba, Córdoba, Argentina.; Romero JJ; Hospital Vozandes, Quito, Ecuador.; Sadino G; Clínica Universitaria Privada Reina Fabiola, Córdoba, Argentina.; Sandoval N; Hospital Roosevelt, Guatemala, Guatemala.; Silva MG; Hospital Zonal General de Agudos Dr. Alberto Eurnekian, Buenos Aires, Argentina.; Smud A; Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.; Soria V; Hospital El Cruce, Buenos Aires, Argentina.; Stanek V; Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.; Torralvo MJ; Hospital Mederi, Bogota, Colombia.; Urueña AM; Maternidad Nuestra Señora De Las Mercedes De Tucumán, Tucumán, Argentina.; Videla H; Instituto de Diagnostico, La Plata, Argentina.; Valle M; Hospital Municipal de Agudos Dr. Leonidas Lucero, Bahía Blanca, Argentina.; Vera Amate Perez S; Hospital Angel C. Padilla, Tucumán, Argentina.; Vergara-Samur H; Hospital Militar Central, Bogotá, Colombia.; Villamandos S; Instituto de Cardiología de Corrientes 'Juana Francisca Cabral,' Corrientes, Argentina.; Villarreal O; Hospital Irma de Lourdes Tzanetatos, Panama, Panama.; Viteri A; Hospital Cesar Milstein, Buenos Aires, Argentina.; Warley E; Clinica Privada Provincial, Buenos Aires, Argentina.; Quiros RE; Sanatorio Las Lomas, Buenos Aires, Argentina. |
| Source: | Open forum infectious diseases [Open Forum Infect Dis] 2024 Oct 11; Vol. 11 (11), pp. ofae620. Date of Electronic Publication: 2024 Oct 11 (Print Publication: 2024). |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Published by Oxford University Press on behalf of the Infectious Diseases Society of America Country of Publication: United States NLM ID: 101637045 Publication Model: eCollection Cited Medium: Print ISSN: 2328-8957 (Print) Linking ISSN: 23288957 NLM ISO Abbreviation: Open Forum Infect Dis Subsets: PubMed not MEDLINE |
| Imprint Name(s): | Original Publication: Cary, NC : Published by Oxford University Press on behalf of the Infectious Diseases Society of America, [2014]- |
| Abstract: | Background: The objective of this study was to identify antibiotic stewardship (AS) opportunities in Latin American medical-surgical intensive care units (MS-ICUs) and general wards (Gral-wards).; Methods: We conducted serial cross-sectional point prevalence surveys in MS-ICUs and Gral-wards in 41 Latin American hospitals between March 2022 and February 2023. Patients >18 years of age in the units of interest were evaluated for antimicrobial use (AU) monthly (MS-ICUs) or quarterly (Gral-wards). Antimicrobial data were collected using a standardized form by the local AS teams and submitted to the coordinating team for analysis.; Results: We evaluated AU in 5780 MS-ICU and 7726 Gral-ward patients. The hospitals' median bed size (interquartile range) was 179 (125-330), and 52% were nonprofit. The aggregate AU prevalence was 53.5% in MS-ICUs and 25.5% in Gral-wards. Most (88%) antimicrobials were prescribed to treat infections, 7% for surgical prophylaxis and 5% for medical prophylaxis. Health care-associated infections led to 63% of MS-ICU and 38% of Gral-ward AU. Carbapenems, piperacillin-tazobactam, intravenous (IV) vancomycin, and ampicillin-sulbactam represented 50% of all AU to treat infections. A minority of IV vancomycin targeted therapy was associated with documented methicillin-resistant Staphylococcus aureus infection or therapeutic drug monitoring. In both units, 17% of antibiotics prescribed as targeted therapy represented de-escalation, while 24% and 15% in MS-ICUs and Gral-wards, respectively, represented an escalation of therapy. In Gral-wards, 32% of antibiotics were used without a microbiologic culture ordered. Half of surgical prophylaxis antibiotics were prescribed after the first 24 hours.; Conclusions: Based on this cohort, areas to improve AU in Latin American hospitals include antibiotic selection, de-escalation, duration of therapy, and dosing strategies.; (© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America.) |
| Competing Interests: | Potential conflicts of interest. The authors declare no conflicts of interest. |
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| Contributed Indexing: | Keywords: Latin America; antibiotic resistance; antibiotic use; antimicrobial stewardship; strategies |
| Entry Date(s): | Date Created: 20241104 Latest Revision: 20241105 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC11530953 |
| DOI: | 10.1093/ofid/ofae620 |
| PMID: | 39494448 |
| Database: | MEDLINE |
Journal Article