A complete and multifaceted overview of antibiotic use and infection diagnosis in the intensive care unit: results from a prospective four-year registration
Abstract Background Preparing an antibiotic stewardship program requires detailed information on overall antibiotic use, prescription indication and ecology. However, longitudinal data of this kind are scarce. Computerization of the patient chart has offered the potential to collect complete data of...
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| Format: | Article |
| Language: | English |
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BMC
2018-09-01
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| Series: | Critical Care |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13054-018-2178-7 |
| _version_ | 1811268470497607680 |
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| author | Liesbet De Bus Bram Gadeyne Johan Steen Jerina Boelens Geert Claeys Dominique Benoit Jan De Waele Johan Decruyenaere Pieter Depuydt |
| author_facet | Liesbet De Bus Bram Gadeyne Johan Steen Jerina Boelens Geert Claeys Dominique Benoit Jan De Waele Johan Decruyenaere Pieter Depuydt |
| author_sort | Liesbet De Bus |
| collection | DOAJ |
| description | Abstract Background Preparing an antibiotic stewardship program requires detailed information on overall antibiotic use, prescription indication and ecology. However, longitudinal data of this kind are scarce. Computerization of the patient chart has offered the potential to collect complete data of high resolution. To gain insight in our global antibiotic use, we aimed to explore antibiotic prescription in our intensive care unit (ICU) from various angles over a prolonged time period. Methods We studied all adult patients admitted to Ghent University Hospital ICU from 1 January 2013 until 31 December 2016. Antibiotic prescription data were prospectively merged with diagnostic (suspected focus, severity and probability of infection at the time of prescription, or prophylaxis) and microbiology data by ICU physicians during daily workflow through dedicated software. Definite focus of infection and probability of infection (classified as high/moderate/low) were reassessed by dedicated ICU physicians at patient discharge. Results During the study period, 8763 patients were admitted and overall antibiotic consumption amounted to 1232 days of therapy (DOT)/1000 patient days. Antibacterial DOT (84% of total DOT) were linked with infection in 80%; the predominant foci were the respiratory tract (49%) and the abdomen (19%). A microbial cause was identified in 56% (3169/5686). Moderate/low probability infections accounted for 42% of antibacterial DOT prescribed for respiratory tract infections; for abdominal infections, this figure was 15%. The median treatment duration of moderate/low probability respiratory infections was 4 days (IQR 3–7). Antifungal DOT (16% of total DOT) were linked with infection in 47% of total antifungal DOT. Antifungal prophylaxis was primarily administered in the surgical ICU (76%), with a median duration of 4 DOT (IQR 2–9). Conclusions By prospectively combining antibiotic, microbiology and clinical data we were able to construct a longitudinal, multifaceted dataset on antibiotic use and infection diagnosis. A complete overview of this kind may allow the identification of antibiotic prescription patterns that require future antibiotic stewardship attention. |
| first_indexed | 2024-04-12T21:23:28Z |
| format | Article |
| id | doaj.art-3cdaa0f34bec4d4cbc7b392d62aac923 |
| institution | Directory Open Access Journal |
| issn | 1364-8535 |
| language | English |
| last_indexed | 2024-04-12T21:23:28Z |
| publishDate | 2018-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Critical Care |
| spelling | doaj.art-3cdaa0f34bec4d4cbc7b392d62aac9232022-12-22T03:16:14ZengBMCCritical Care1364-85352018-09-0122111010.1186/s13054-018-2178-7A complete and multifaceted overview of antibiotic use and infection diagnosis in the intensive care unit: results from a prospective four-year registrationLiesbet De Bus0Bram Gadeyne1Johan Steen2Jerina Boelens3Geert Claeys4Dominique Benoit5Jan De Waele6Johan Decruyenaere7Pieter Depuydt8Department of Critical Care Medicine, Ghent University HospitalDepartment of Critical Care Medicine, Ghent University HospitalDepartment of Critical Care Medicine, Ghent University HospitalDepartment of Laboratory Medicine, Ghent University HospitalDepartment of Laboratory Medicine, Ghent University HospitalDepartment of Critical Care Medicine, Ghent University HospitalDepartment of Critical Care Medicine, Ghent University HospitalDepartment of Critical Care Medicine, Ghent University HospitalDepartment of Critical Care Medicine, Ghent University HospitalAbstract Background Preparing an antibiotic stewardship program requires detailed information on overall antibiotic use, prescription indication and ecology. However, longitudinal data of this kind are scarce. Computerization of the patient chart has offered the potential to collect complete data of high resolution. To gain insight in our global antibiotic use, we aimed to explore antibiotic prescription in our intensive care unit (ICU) from various angles over a prolonged time period. Methods We studied all adult patients admitted to Ghent University Hospital ICU from 1 January 2013 until 31 December 2016. Antibiotic prescription data were prospectively merged with diagnostic (suspected focus, severity and probability of infection at the time of prescription, or prophylaxis) and microbiology data by ICU physicians during daily workflow through dedicated software. Definite focus of infection and probability of infection (classified as high/moderate/low) were reassessed by dedicated ICU physicians at patient discharge. Results During the study period, 8763 patients were admitted and overall antibiotic consumption amounted to 1232 days of therapy (DOT)/1000 patient days. Antibacterial DOT (84% of total DOT) were linked with infection in 80%; the predominant foci were the respiratory tract (49%) and the abdomen (19%). A microbial cause was identified in 56% (3169/5686). Moderate/low probability infections accounted for 42% of antibacterial DOT prescribed for respiratory tract infections; for abdominal infections, this figure was 15%. The median treatment duration of moderate/low probability respiratory infections was 4 days (IQR 3–7). Antifungal DOT (16% of total DOT) were linked with infection in 47% of total antifungal DOT. Antifungal prophylaxis was primarily administered in the surgical ICU (76%), with a median duration of 4 DOT (IQR 2–9). Conclusions By prospectively combining antibiotic, microbiology and clinical data we were able to construct a longitudinal, multifaceted dataset on antibiotic use and infection diagnosis. A complete overview of this kind may allow the identification of antibiotic prescription patterns that require future antibiotic stewardship attention.http://link.springer.com/article/10.1186/s13054-018-2178-7Antibiotic stewardshipIntensive care unitElectronic surveillanceLongitudinal surveillanceInfection |
| spellingShingle | Liesbet De Bus Bram Gadeyne Johan Steen Jerina Boelens Geert Claeys Dominique Benoit Jan De Waele Johan Decruyenaere Pieter Depuydt A complete and multifaceted overview of antibiotic use and infection diagnosis in the intensive care unit: results from a prospective four-year registration Critical Care Antibiotic stewardship Intensive care unit Electronic surveillance Longitudinal surveillance Infection |
| title | A complete and multifaceted overview of antibiotic use and infection diagnosis in the intensive care unit: results from a prospective four-year registration |
| title_full | A complete and multifaceted overview of antibiotic use and infection diagnosis in the intensive care unit: results from a prospective four-year registration |
| title_fullStr | A complete and multifaceted overview of antibiotic use and infection diagnosis in the intensive care unit: results from a prospective four-year registration |
| title_full_unstemmed | A complete and multifaceted overview of antibiotic use and infection diagnosis in the intensive care unit: results from a prospective four-year registration |
| title_short | A complete and multifaceted overview of antibiotic use and infection diagnosis in the intensive care unit: results from a prospective four-year registration |
| title_sort | complete and multifaceted overview of antibiotic use and infection diagnosis in the intensive care unit results from a prospective four year registration |
| topic | Antibiotic stewardship Intensive care unit Electronic surveillance Longitudinal surveillance Infection |
| url | http://link.springer.com/article/10.1186/s13054-018-2178-7 |
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