Antimicrobial stewardship programs in adult intensive care units in Latin America: Implementation, assessments, and impact on outcomes

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dc.contributor.authorQuirós, Rodolfo E.
dc.contributor.authorBardossy, Ana C.
dc.contributor.authorAngeleri, Patricia
dc.contributor.authorZurita, Jeannete
dc.contributor.authorAleman Espinoza, Washington R.
dc.contributor.authorCarneiro, Marcelo
dc.contributor.authorGuerra, Silvia
dc.contributor.authorMedina, Julio
dc.contributor.authorCastañeda Luquerna, Ximena
dc.contributor.authorGuerra, Alexander
dc.contributor.authorVega, Silvio
dc.contributor.authorCuellar Ponce de Leon, Luis E.
dc.contributor.authorMunita, José
dc.contributor.authorEscobar, Elvio D.
dc.contributor.authorMaki, Gina
dc.contributor.authorPrentiss, Tyler
dc.contributor.authorZervos, Marcus
dc.contributor.authorPROA-LATAM Project Group
dc.date.accessioned2022-01-11T19:12:55Z
dc.date.available2022-01-11T19:12:55Z
dc.date.issued2021
dc.description.abstractAbstract Objective: To assess the impact of antimicrobial stewardship programs (ASPs) in adult medical–surgical intensive care units (MS-ICUs) in Latin America. Design: Quasi-experimental prospective with continuous time series. Setting: The study included 77 MS-ICUs in 9 Latin American countries. Patients: Adult patients admitted to an MS-ICU for at least 24 hours were included in the study. Methods: This multicenter study was conducted over 12 months. To evaluate the ASPs, representatives from all MS-ICUs performed a self-assessment survey (0–100 scale) at the beginning and end of the study. The impact of each ASP was evaluated monthly using the following measures: antimicrobial consumption, appropriateness of antimicrobial treatments, crude mortality, and multidrug-resistant microorganisms in healthcare-associated infections (MDRO-HAIs). Using final stewardship program quality self-assessment scores, MS-ICUs were stratified and compared among 3 groups: ≤25th percentile, >25th to <75th percentile, and ≥75th percentile. Results: In total, 77 MS-ICU from 9 Latin American countries completed the study. Twenty MS-ICUs reached at least the 75th percentile at the end of the study in comparison with the same number who remain within the 25th percentile (score, 76.1 ± 7.5 vs 28.0 ± 7.3; P < .0001). Several indicators performed better in the MS-ICUs in the 75th versus 25th percentiles: antimicrobial consumption (143.4 vs 159.4 DDD per 100 patient days; P < .0001), adherence to clinical guidelines (92.5% vs 59.3%; P < .0001), validation of prescription by pharmacist (72.0% vs 58.0%; P < .0001), crude mortality (15.9% vs 17.7%; P < .0001), and MDRO-HAIs (9.45 vs 10.96 cases per 1,000 patient days; P = .004). Conclusion: MS-ICUs with more comprehensive ASPs showed significant improvement in antimicrobial utilization.es
dc.description.versionVersión publicada
dc.identifier.citationQuirós RE, Bardossy AC, Angeleri P, Zurita J, Aleman Espinoza WR, Carneiro M, Guerra S, Medina J, Castañeda Luquerna X, Guerra A, Vega S, Cuellar Ponce de Leon LE, Munita J, Escobar ED, Maki G, Prentiss T, Zervos M; PROA-LATAM Project Group. Antimicrobial stewardship programs in adult intensive care units in Latin America: Implementation, assessments, and impact on outcomes. Infect Control Hosp Epidemiol. 2021 Apr 8:1-10. doi:10.1017/ice.2021.80es
dc.identifier.urihttps://doi.org/10.1017/ice.2021.80es
dc.identifier.urihttp://hdl.handle.net/11447/5430
dc.language.isoenes
dc.subjectAnti-Bacterial Agents / administration & dosagees
dc.subjectAnti-Bacterial Agents / therapeutic usees
dc.subjectAnti-Infective Agents / administration & dosagees
dc.subjectAnti-Infective Agents / therapeutic usees
dc.subjectAntimicrobial Stewardship / methodses
dc.subjectCross Infection / epidemiologyes
dc.subjectIntensive Care Units / statistics & numerical dataes
dc.subjectLongitudinal Studieses
dc.subjectMiddle Agedes
dc.subjectTreatment Outcomees
dc.subjectAntimicrobiales
dc.titleAntimicrobial stewardship programs in adult intensive care units in Latin America: Implementation, assessments, and impact on outcomeses
dc.typeArticlees
dcterms.sourceInfection Control & Hospital Epidemiologyes

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