2003
DOI: 10.1590/s1413-86702003000500002
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Abstract: There are various strategies to improve the effectiveness of antibiotics in hospitals. In general, the implementation of guidelines for appropriate antibiotic therapy and the participation of infectious disease (ID) physicians deserve considerable attention. This study was a prospective ecological time-series study that evaluates the effectiveness of the ID physician's opinion to rationalize and control the use of antibiotics in medical-surgical intensive care units (

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Cited by 8 publications
(8 citation statements)
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“…The ICU of Hospital Santa Luzia employs a well designed strategy for controlling and rationalising antibacterial therapy, including revision and restriction of the use of antibacterial agents in the hospital, implementation of the guidelines for the empirical use of antimicrobials in the treatment of hospitalacquired pneumonias (the most frequent class of infection encountered in an ICU), and the requirement that a physician specialising in infectious diseases be consulted in relation to the antimicrobial therapy provided for patients with defined and/or suspected infection [13]. Despite such measures, however, the ICU was unable to achieve the standards followed in developed countries, and there are various possible explanations for this situation.…”
Section: Discussionmentioning
confidence: 99%
See 1 more Smart Citation
“…The ICU of Hospital Santa Luzia employs a well designed strategy for controlling and rationalising antibacterial therapy, including revision and restriction of the use of antibacterial agents in the hospital, implementation of the guidelines for the empirical use of antimicrobials in the treatment of hospitalacquired pneumonias (the most frequent class of infection encountered in an ICU), and the requirement that a physician specialising in infectious diseases be consulted in relation to the antimicrobial therapy provided for patients with defined and/or suspected infection [13]. Despite such measures, however, the ICU was unable to achieve the standards followed in developed countries, and there are various possible explanations for this situation.…”
Section: Discussionmentioning
confidence: 99%
“…However, certain regions enjoy a low frequency of resistant microorganisms, as is the case for Swedish ICUs where methicillin-sensitive Staphylococcus aureus is prevalent [12]. Moreover, access to advice from consultants with particular expertise in specific infectious diseases may permit the optimisation of appropriate therapy and hence minimise the utilisation of drugs [13]. It is possible that the interaction between the frequency of bacterial resistance, the effective adhesion to control and rationalisation of therapy, and various other factors that are specific to the ICU (such as the type of patient admitted, availability of material and human resources, level of organisation) may account for the differences in the pattern of usage of antibacterial agents between the ICUs.…”
Section: Discussionmentioning
confidence: 99%
“…It represents a multifaceted approach that includes many components, and each individual ASP might encompass several, but not all, of them at a given time. These components include audits [57] , infectious disease specialist or senior clinician input [58][59][60][61][62][63][64] , or planned discontinuation/deescalation of treatment in response to clinical and microbiological outcome data [65] . Other components include rotating antibiotic schedules [57,[66][67][68][69][70] changes in prescribing policies involving antibiotic restriction, different dosing regimens or prophylaxis protocols [57,62,65,67,[71][72][73][74][75][76][77][78][79][80][81][82][83][84] and a multi-disciplinary team (MDT) approach in treatment initiation and discontinuation, often emphasising feedback and non-punitive atmosphere among staff members [83,85] .…”
Section: Discussionmentioning
confidence: 99%
“…glycopeptides, or carbapenems. Although several studies have focused on the antibiotic control programs [17,18], few have documented the effectiveness of the interventions on the antibiotic usage in a Chinese PICU. Our study revealed the effectiveness of the intervention for antibiotic use by implementing and maintaining a guideline in the PICU at Beijing Children's Hospital.…”
Section: Discussionmentioning
confidence: 99%