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Retrospective evaluation of piperacillin-tazobactam, imipenem-cilastatin and meropenem used on surgical floors at a tertiary care hospital in Saudi Arabia.
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- Author(s): Youssif E;Youssif E; Aseeri M; Aseeri M; Khoshhal S; Khoshhal S
- Source:
Journal of infection and public health [J Infect Public Health] 2018 Jul - Aug; Vol. 11 (4), pp. 486-490. Date of Electronic Publication: 2017 Nov 15.
- Publication Type:
Evaluation Study; Journal Article
- Language:
English
- Additional Information
- Source:
Publisher: Elsevier Country of Publication: England NLM ID: 101487384 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1876-035X (Electronic) Linking ISSN: 18760341 NLM ISO Abbreviation: J Infect Public Health Subsets: MEDLINE
- Publication Information:
Original Publication: Oxford : Elsevier, 2008-
- Subject Terms:
- Abstract:
Background: The appropriate use of broad-spectrum antibiotics, including appropriate de-escalation, is essential to reduce the emergence of antibiotic resistance. In surgical floors antibiotics are prescribed for prophylaxis (mostly, single dose), empirical treatment (started if infection is suspected till bacteria are identified with its sensitivity to antibiotics), or treatment of well-defined infection of previously isolated bacteria with its sensitivity to antibiotics. In this study, we aimed to evaluate the use of broad-spectrum antibiotics based on requests for cultures and de-escalation based on sensitivity results of culture tests at tertiary care hospital.
Method: A retrospective cohort study was conducted to evaluate the utilization of broad-spectrum antibiotics on surgical floors at a tertiary care center in Jeddah, Saudi Arabia. Patients who are admitted to surgical floors were included if they received any of three broad-spectrum antibiotics (piperacillin-tazobactam, imipenem-cilastatin or meropenem) from 1 June 2014 to 31 August 2014. Data were collected on whether culture and sensitivity test requests were made within 24h of starting antibiotics, the duration of antibiotic therapy and the number of days to de-escalation after receiving culture and sensitivity results.
Results: Of the 163 patients who received broad-spectrum antibiotics, culture tests were requested in 112. Before receiving culture results, one patient was discharged and one died. The results of culture tests justified continuation of broad-spectrum antibiotics in only 22 patients, whereas 24 showed no microbial growth in any culture. De-escalation was delayed >24h after culture results became available in 33 out of 64 eligible patients. On the other hand, 51 patients continued receiving broad spectrum antibiotics without any culture test during the whole treatment course.
Conclusion: The use of broad-spectrum antibiotics in surgical floors at a tertiary care hospital in Saudi Arabia was largely unjustified by culture-test result. Interventions are needed to enforce culture and sensitivity test requests within 24h of starting the broad spectrum antibiotics therapy with further follow up to ensure appropriate de-escalation and discontinuation whenever indicated.
(Copyright © 2017. Published by Elsevier Ltd.)
- Contributed Indexing:
Keywords: Antimicrobial stewardship; De-escalation; Imipenem–cilastatin; Meropenem; Microbial drug resistance; Piperacillin–tazobactam; Surgical
- Accession Number:
0 (Anti-Bacterial Agents)
0 (Drug Combinations)
0 (Thienamycins)
141A6AMN38 (Cilastatin)
157044-21-8 (Piperacillin, Tazobactam Drug Combination)
71OTZ9ZE0A (Imipenem)
87-53-6 (Penicillanic Acid)
92309-29-0 (Cilastatin, Imipenem Drug Combination)
FV9J3JU8B1 (Meropenem)
X00B0D5O0E (Piperacillin)
- Publication Date:
Date Created: 20171121 Date Completed: 20181109 Latest Revision: 20191210
- Publication Date:
20231215
- Accession Number:
10.1016/j.jiph.2017.09.001
- Accession Number:
29153444
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