Antibiotic treatment of healthcare-associated infections

A periodical review of healthcare-associated infections in a urology ward led to changes in the prescriptions of antibiotics, aimed to optimise the management of infections [1]. Healthcare-associated infections included urinary tract infections and surgical wound infections.

Inadequate antibiotic treatment for infections has negative consequences in terms of morbidity and even mortality. On top of that, inadequate antibiotic treatment could lead to the development of multi-drug resistant microorganisms. Regular assessment of the characteristics of infections, including susceptibility patterns, leads to optimisation of antibiotic treatment selection.

A study presented by Dr José Medina-Polo (Hospital Universitario 12 de Octubre, Madrid, Spain) analysed the evolution of antibiotic prescription in patients with healthcare-associated infections who were hospitalised in their urology department from 2012 to 2020. Between 2012 and 2015, the most frequently used antibiotics were third and fourth generation cephalosporins (36.9–48.2%). From 2016 onwards, carbapenems were most frequently prescribed (41.5–51.1%).

Due to the updated protocol for empirical treatment in 2020, the prescription of carbapenems decreased to 28.6% and the prescription of third and fourth generation cephalosporins became 42.9%. From 2012 to 2020, the empirical prescription of quinolones decreased from 6.4% to 1.8%.

During the study period, it was increasingly common to change antibiotics in case an antibiogram (i.e. the antibiotic resistance patterns) was available, aimed to reduce the antibiotic spectrum. Once the antibiogram was available, cephalosporins were more frequently prescribed (55.2%) than carbapenems (12.5%).

These results demonstrated that it is essential to review the antibiogram to select the most appropriate antibiotic and try to reduce the spectrum; thereby minimising the occurrence of multi-drug resistant microorganisms.

1. Medina-Polo J. Evaluation of the evolution of antibiotic prescription in the treatment of Healthcare-Associated Infections (HAIs) in a urology ward after implementing a treatment optimisation programme. P0163, EAU21 Virtual, 8–12 July 2021.

 

Copyright ©2021 Medicom Medical Publishers



Posted on 31 August 2021