Abstract
BackgroundThis study aimed to evaluate the oral switch (OS) stewardship intervention in the intensive care unit (ICU).MethodsThis was a retrospective study with a convenience sample in two Brazilian ICUs from different hospitals in patients with sepsis receiving antibiotic therapy. The stewardship intervention included OS in patients diagnosed with sepsis when clinical stability was achieved. The primary outcome was overall mortality. Other variables evaluated were as follows: cost of antimicrobial treatment, daily costs of intensive care, acute kidney injury, and length of stay.ResultsThere was no difference in mortality between the OS and non-OS groups (p = 0.06). Length of stay in the ICU (p = 0.029) was shorter and acute kidney injury incidence (p = 0.032) and costs of antimicrobial therapy (p < 0.001) were lower in the OS group.ConclusionOS stewardship programs in the ICU may be considered a safe strategy. Switch therapy reduced the cost and shortened the length of stay in ICUs.
Highlights
This study aimed to evaluate the oral switch (OS) stewardship intervention in the intensive care unit (ICU)
An antimicrobial stewardship program can be defined as the set of actions performed in hospitals for the rational use of antibiotics; reduction of adverse events, dosage errors, and appearance of multiresistant bacteria; and shortening of length of hospital stay
Patient inclusion was performed at two hospitals in the city of Curitiba: a 207-bed public school hospital (Hospital Universitário Cajuru), whose ICU is a referral center for the care of patients with trauma, and a 210bed hospital (Hospital Santa Casa de Curitiba), with an ICU specializing in clinical and surgical care
Summary
This study aimed to evaluate the oral switch (OS) stewardship intervention in the intensive care unit (ICU). Length of stay in the ICU (p = 0.029) was shorter and acute kidney injury incidence (p = 0.032) and costs of antimicrobial therapy (p < 0.001) were lower in the OS group. Switch therapy reduced the cost and shortened the length of stay in ICUs. An antimicrobial stewardship program can be defined as the set of actions performed in hospitals for the rational use of antibiotics; reduction of adverse events, dosage errors, and appearance of multiresistant bacteria; and shortening of length of hospital stay. Managed antimicrobial administration programs shorten the length of hospital stay and reduce costs associated with the use of these medications. There are some concerns, some classes of antimicrobials have oral bioavailability similar to that in IV administration, such as quinolones, even when administered in critically ill patients [5]
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