Restricted use antimicrobials and their use in the microbiological context in a Private Hospital in Salvador

• DOI: 10.22533/at.ed.813272220106

• Palavras-chave: Antimicrobials, microbiology, bacterial pharmacoresistance

• Keywords: Antimicrobials, microbiology, bacterial pharmacoresistance

• Abstract:

  The objective of this study was to identify the consumption of antimicrobials over the years, as well as the relationship of prescriptions in the microbiological profile and in the rates of HAI in the hospital unit. To standardize the calculation, surveillance of consumption of Vancomycin and Teicoplanin was established as restricted for gram positives and Meropenem and Imipenem as restricted for gram negatives. When comparing the prevalence of use of antimicrobials, we found that only in 2009 there was an adequacy of prescription for the identification of microorganisms. All cultures carried out from January 2007 to December 2010 were evaluated and compared year by year. In all years, gram negative agents predominated. HAI rates did not show a statistically significant change over the years. In a second analysis, we found that there was an increase in the prescription of antimicrobials when compared from 2008 to 2007. In the other years, the prescription remained constant. However, the increase in resistance to Vancomycin was progressive. In 2007 the percentage of MRSA was 37.5; followed by 42.1 in 2008; 46.15 in 2009; 64.7 in 2010. After this analysis and considering that in 2007 the percentage of resistance to oxacillin was 37.5%, and 64.7% in 2010, the proposal is to reassess the prescription of first-line antimicrobials at the beginning of treatment. Safe prescribing is the best way to reduce resistance. Further studies will be needed to better understand the impact of medical prescription on antibiotic resistance.