Antimicrobial Therapy Management Program in a hospital: indicators and pharmacoeconomic study
Main Article Content
Abstract
Objective: To describe the pharmacoeconomic study of an Antimicrobial Therapy Management Program carried out in a hospital. Methods: Study from 2019 to 2021, exploratory, descriptive and quantitative, on a management program, bringing the proposed intervention based on the prospective audit of antimicrobial therapy, revealing its data in the form of indicators. Applied to cost-minimization analysis. The data were analyzed using descriptive statistics using the IBM SPSS Statistics software. The study was approved by the Research Ethics Committee. Results: 2993 patients were followed. In the findings, an average use of 2.5 antimicrobials, 1.6 strategies proposed per patient and an acceptance rate of 97.4% (n= 5718). The average minimized direct cost rate was 32.5% (R$68,407.21) per month, and R$685.67 saved by each patient. It was also estimated that if the study had full bed coverage from the beginning of the Program's implementation, this could increase the total minimized direct cost of the study by 17.2% (R$353,220.61). Conclusion: The Program proved to be effective in reducing the direct cost of antimicrobials through the strategies proposed by the multidisciplinary team.
Article Details
Copyright © | All rights reserved.
The journal holds the exclusive copyright for the publication of this article under the terms of Brazilian law 9610/98.
Partial reproduction
The use of parts of the texts, figures and questionnaire of the article is free, being mandatory the citation of the authors and journal.
Total reproduction
It is expressly prohibited and must be authorized by the journal.
References
2. CONOVER, WJ. 1971. Practical nonparametric statistics. London, Sidney: Wiley & Sons. 462p.
3. CRESPO-RIVAS JC, et al. Are antimicrobial stewardship interventions effective and safe in long-term care facilities? A systematic review and meta-analysis. Clinical microbiology and infection: the official publication of the European Society of Clinical Microbiology and Infectious Diseases, 2021; 27(10): 1431-1438.
4. DE WAELE J, et al. Antimicrobial de-escalation as part of antimicrobial stewardship in intensive care: no simple answers to simple questions - a viewpoint of experts. Intensive Care Med, 2020; 46: 236 – 244.
5. Diretriz Nacional para Elaboração de Programa de Gerenciamento do Uso de Antimicrobianos em Serviços de Saúde. Agência Nacional de Vigilância Sanitária. Brasília, p. 96 dez, 2017. Disponível em: https://antigo.anvisa.gov.br/documents/33852/271855/Diretriz+Nacional+para+ Elabora%C3%A7%C3%A3o+de+Programa+de+Gerenciamento+do+Uso+de+Antimicrobianos+em+Servi%C3%A7os+de+Sa%C3%BAde/667979c2-7edc-411b-a7e0-49a6448880d4?version=1.0. Acessado em: 15 de outubro de 2022.
6. KHDOUR M, et al. Impact of antimicrobial stewardship programme on hospitalized patients at the intensive care unit: a prospective audit and feedback study. British Journal of Clinical Pharmacology, 2018; 84: 708-715.
7. HOLGUÍN H, et al. Intervenciones farmacéuticas y desenlaces clínicos en un programa de gerenciamiento de antimicrobianos. Revista Chilena Infectologia, 2020; 37(4): 343-348.
8. HSIEH CL, et al. Intervenciones farmacéuticas y desenlaces clínicos en un programa de gerenciamiento de antimicrobianos. Revista Chilena Infectologia, 2020; 37(4): 343-348.
9. HUTTNER BD, et al. COVID-19: don't neglect antimicrobial stewardship principles! Clinical Microbiology and Infection, 2020; 26: 808-810.
10. LUCIEN MAB, et al. Antibiotics and antimicrobial resistance in the COVID-19 era: Perspective from resource-limited settings. Int J Infect Dis, 2021; 104: 250-254.
11. LYNCH C, et al. Antimicrobial stewardship: a COVID casualty?Journal of Hospital Infection, 2020; 106: 401-403.
12. MENDELSON M, et al. How to start an antimicrobial stewardship programme in a hospital. Clinical Microbiology and Infection, 2020; 26: 447 – 453.
13. MONIZ P, et al. Antimicrobial Stewardship in the Intensive Care Unit: The Role of Biomarkers, Pharmacokinetics, and Pharmacodynamics. Advances in therapy, 2021; 38(1): 164-179.
14. MONTRUCCHIO G, et al. Choosing wisely: what is the actual role of antimicrobial stewardship in Intensive Care Units? Minerva Anestesiologica, 2019; 85: 71-82.
15. NATHWANI D, et al. Value of hospital antimicrobial stewardship programs [ASPs]: a systematic review. Antimicrobial Resistance and Infection Control, 2019; 35(8).
16. TANDAN M, et al. Impact of antimicrobial stewardship program on antimicrobial-resistance and prescribing in nursing homes: a systematic review and meta-analysis. J Glob Antimicrob Resist, 2022; 29: 74-87.
17. TONIN FS, et al. Principles of pharmacoeconomic analysis: the case of pharmacist-led interventions. Pharm Pract (Granada), 2021; 19(1): e2302.
18. TROMBOLD N e AWAD D. The economic opportunity of departmental training during pandemic scenarios: Concepts and analyses. Am J Health Syst Pharm, 2021; 78(23): 2164-2166.
19. VAN DER POL S, et al. Economic Analyses of Respiratory Tract Infection Diagnostics: A Systematic Review. Pharmacoeconomics, 2021; 39(12): 1411-1427.
20. WALLEY T, HAYCOX A. Pharmacoeconomics: basic concepts and terminology. British journal of clinical pharmacology, 1997; 43(4): 343-348.
21. WANG H, et al. Impact of antimicrobial stewardship managed by clinical pharmacists on antibiotic use and drug resistance in a Chinese hospital, 2010-2016: a retrospective observational study. BMJ Open, 2019; 9(8): e026072.