Antimicrobial resistance is one of the key issues limiting the successful treatment of infectious diseases and associated with adverse medical, social and economic consequences on a global scale. The present study aims to evaluate antimicrobials prescribing patterns and assess progress in quality indicators in Russian multidisciplinary hospitals using three repetitive point prevalence studies (PPSs) over 4 years (Global-PPS 2015, 2017 and 2018). Out of 13,595 patients from 21 hospitals surveyed over the three time points, 3542 (26.14%) received antimicrobials, predominantly third-generation cephalosporins (44.7% in 2015, 34.1% in 2017 and 41.8% in 2018). Compliance with the hospital antibiotic guidelines was 74.8%, 66.8% and 74.3%, respectively. Indication for treatment was recorded in 72.6%, 84.1% and 82.6%, while stop/review date was documented only in 40.5%, 46.5% and 61.1% of cases. Perioperative antibiotic prophylaxis exceeded 1 day in 92%, 84% and 81% of cases. Targeted therapy rate at all time points did not exceed 15.1%, treatment based on the biomarkers rate—19.9%. For the part of PPS-2017 and 2018 analyzed in dynamics, no prominent trends were noted. The results of the project provide the basis for the development of appropriate antimicrobial stewardship programs tailored according to local practices for each hospital in the project.
Objective. assessment of the evolution of the microbiological landscape of the hospital for the period of operation in 2020 into a pandemic of a new coronavirus infection in various departments, including intensive care units; change depending on the results of antibacterial therapy regimens. Materials and Methods. In a retrospective study, conducted from June to December 2020, in a multidisciplinary hospital working with COVID-19 infection, the resistance of isolated strains of microorganisms was analyzed in patients of different age groups. Resistance was assessed with test points in June and November 2020; depending on this, proposals were made to correct the internal (local) protocols of antimicrobial therapy. Results. The need for frequent and regular microbiological monitoring was confirmed. Further, we understood that the territories of the main and temporary hospital of the City Clinical Hospital No. 40 are heterogeneous and there are obvious differences both in structure and in the level of sensitivity. “In practice, these are two different hospitals”. Within the territories, the branches also differ from each other. When analyzing resistance in ICUs, it was revealed that within each hospital in each department, albeit similar in structure and profile of patients, there is a different level of resistance of strains. Conclusions. The structure of sensitivity generally corresponds to the world data, but for some pathogens it differs significantly. Microbiological monitoring should be carried out not only inside the hospital, but also inside the department. The increase in consumption of carbapenems and protected cephalosporins requires a reassessment of the practice of using AMP in any covid hospital, due to the impact on the epidemic situation both in the ICUs and in the hospital.
Aim. The study was conducted to assess the level of awareness of surgeons about the principles of safe perioperative pharmacotherapy.Materials and methods. The survey of surgeons was conducted in 2018 on the basis of a questionnaire made by the authors, consisting of 60 questions and tasks, divided into 6 thematic blocks. The respondents had to demonstrate their knowledge both in the field of general principles of safe pharmacotherapy and private issues of using analgesics, anticoagulants, antibiotics in the perioperative period. The results of the survey were assessed as a percentage (proportion of correct answers) individually for each respondent and in total.Results. The results of the survey showed a lack of a deep understanding of the principles of safe pharmacotherapy in most clinical cases. Despite the fact that a number of answers completely correlated with the positions of evidence-based medicine, in general, there was a lack of systemic knowledge. The survey made it possible to identify those important points that should be first highlighted in the preparation of the training program. Conclusion. Every doctor should strive to minimize the preventable medical errors associated with pharmacotherapy. This is feasible only in the process of continuous daily learning. Practitioners' interest in the efficacy and safety of pharmacotherapy and mastering the basic decision-making algorithms for prescribing, controlling safety and cancelling drugs will improve the quality of medical care.
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