Antimicrobial therapy in older adults: profile of use and evaluation of the quality of prescription

Objectives: To analyze the point prevalence of antimicrobial agent use by older adults and to determine the quality of use in a teaching hospital. A pharmacoepidemiological, observational study. Methods: Retrospective collection of clinical, microbiological and pharmacotherapeutic data in medical r...

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Autores principales:	Luana F. CRUZ, Ana G. MARÇAL, Adriano M. REIS, Caryne M. BERTOLLO
Formato:	article
Lenguaje:	EN PT
Publicado:	Sociedade Brasileira de Farmácia Hospitalar e Serviços de Saúde 2020
Materias:	Public aspects of medicine RA1-1270 Pharmacy and materia medica RS1-441 Therapeutics. Pharmacology RM1-950
Acceso en línea:	https://doaj.org/article/e18708b0ddd1410cb95c7b6ae44460dc
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spelling	oai:doaj.org-article:e18708b0ddd1410cb95c7b6ae44460dc2021-11-28T02:45:12ZAntimicrobial therapy in older adults: profile of use and evaluation of the quality of prescription10.30968/rbfhss.2020.111.03672179-59242316-7750https://doaj.org/article/e18708b0ddd1410cb95c7b6ae44460dc2020-07-01T00:00:00Zhttps://www.rbfhss.org.br/sbrafh/article/view/367https://doaj.org/toc/2179-5924https://doaj.org/toc/2316-7750 Objectives: To analyze the point prevalence of antimicrobial agent use by older adults and to determine the quality of use in a teaching hospital. A pharmacoepidemiological, observational study. Methods: Retrospective collection of clinical, microbiological and pharmacotherapeutic data in medical records. Inclusion criteria: age ≥ 60 years old, in use of one or more antimicrobial agents. The resistant microorganisms classified as priority pathogens by the World Health Organization (WHO) were identified. The quality of antimicrobial agent use according to quality indicators described by Van den Bosch et al. (2015) was determined. A descriptive statistical analysis was performed. Results: Of the 130 hospitalized older adult individuals, 40.8% were using one or more antimicrobials agents on the day of point prevalence. Among the 50 resistant microorganisms identified in the cultures, 54.0% corresponded to pathogens of critical priority. Antibiotic glycopeptides (14.9%) and penicillins associated with beta-lactamase inhibitors (13.8%) were the most prescribed classes of antimicrobial agents. The Quality Indicators (QIs) of antimicrobial therapy demonstrated more frequent inadequacy regarding therapeutic monitoring, sequential therapy and blood culture request. Conclusions: The prevalence of antimicrobial agent use in older adults was high. Empirical therapy is often developed in line with that advocated by the Infection Control Commission. The high isolation of critical pathogens according to the WHO, evidences the importance of actions to ensure the rational use of drugs in the institution. The QIs demonstrated the need to implement guidelines for systematizing therapeutic antimicrobial agent monitoring in the institution and educational action on the process of requesting blood cultures. Luana F. CRUZAna G. MARÇALAdriano M. REISCaryne M. BERTOLLOSociedade Brasileira de Farmácia Hospitalar e Serviços de SaúdearticlePublic aspects of medicineRA1-1270Pharmacy and materia medicaRS1-441Therapeutics. PharmacologyRM1-950ENPTRevista Brasileira de Farmácia Hospitalar e Serviços de Saúde, Vol 11, Iss 1 (2020)
institution	DOAJ
collection	DOAJ
language	EN PT
topic	Public aspects of medicine RA1-1270 Pharmacy and materia medica RS1-441 Therapeutics. Pharmacology RM1-950
spellingShingle	Public aspects of medicine RA1-1270 Pharmacy and materia medica RS1-441 Therapeutics. Pharmacology RM1-950 Luana F. CRUZ Ana G. MARÇAL Adriano M. REIS Caryne M. BERTOLLO Antimicrobial therapy in older adults: profile of use and evaluation of the quality of prescription
description	Objectives: To analyze the point prevalence of antimicrobial agent use by older adults and to determine the quality of use in a teaching hospital. A pharmacoepidemiological, observational study. Methods: Retrospective collection of clinical, microbiological and pharmacotherapeutic data in medical records. Inclusion criteria: age ≥ 60 years old, in use of one or more antimicrobial agents. The resistant microorganisms classified as priority pathogens by the World Health Organization (WHO) were identified. The quality of antimicrobial agent use according to quality indicators described by Van den Bosch et al. (2015) was determined. A descriptive statistical analysis was performed. Results: Of the 130 hospitalized older adult individuals, 40.8% were using one or more antimicrobials agents on the day of point prevalence. Among the 50 resistant microorganisms identified in the cultures, 54.0% corresponded to pathogens of critical priority. Antibiotic glycopeptides (14.9%) and penicillins associated with beta-lactamase inhibitors (13.8%) were the most prescribed classes of antimicrobial agents. The Quality Indicators (QIs) of antimicrobial therapy demonstrated more frequent inadequacy regarding therapeutic monitoring, sequential therapy and blood culture request. Conclusions: The prevalence of antimicrobial agent use in older adults was high. Empirical therapy is often developed in line with that advocated by the Infection Control Commission. The high isolation of critical pathogens according to the WHO, evidences the importance of actions to ensure the rational use of drugs in the institution. The QIs demonstrated the need to implement guidelines for systematizing therapeutic antimicrobial agent monitoring in the institution and educational action on the process of requesting blood cultures.
format	article
author	Luana F. CRUZ Ana G. MARÇAL Adriano M. REIS Caryne M. BERTOLLO
author_facet	Luana F. CRUZ Ana G. MARÇAL Adriano M. REIS Caryne M. BERTOLLO
author_sort	Luana F. CRUZ
title	Antimicrobial therapy in older adults: profile of use and evaluation of the quality of prescription
title_short	Antimicrobial therapy in older adults: profile of use and evaluation of the quality of prescription
title_full	Antimicrobial therapy in older adults: profile of use and evaluation of the quality of prescription
title_fullStr	Antimicrobial therapy in older adults: profile of use and evaluation of the quality of prescription
title_full_unstemmed	Antimicrobial therapy in older adults: profile of use and evaluation of the quality of prescription
title_sort	antimicrobial therapy in older adults: profile of use and evaluation of the quality of prescription
publisher	Sociedade Brasileira de Farmácia Hospitalar e Serviços de Saúde
publishDate	2020
url	https://doaj.org/article/e18708b0ddd1410cb95c7b6ae44460dc
work_keys_str_mv	AT luanafcruz antimicrobialtherapyinolderadultsprofileofuseandevaluationofthequalityofprescription AT anagmarcal antimicrobialtherapyinolderadultsprofileofuseandevaluationofthequalityofprescription AT adrianomreis antimicrobialtherapyinolderadultsprofileofuseandevaluationofthequalityofprescription AT carynembertollo antimicrobialtherapyinolderadultsprofileofuseandevaluationofthequalityofprescription
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Antimicrobial therapy in older adults: profile of use and evaluation of the quality of prescription

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