Descalonamento, adequação antimicrobiana e prevalência da prescrição de piperacilina/tazobactam em um hospital geral

Abstract

Background and Objectives: inappropriate use of antibiotics induces antimicrobial resistance (AR) and increases hospital costs, which is associated with inadequate use of antibiotics. The aim of this study was to estimate the prevalence of the antimicrobial agent Piperacillin / Tazobactam (PIP-TZ), as well as its suitability for laboratory tests. Methods: This cross-sectional, descriptive and analytical study analyzed the medical records of patients submitted to antimicrobial therapy with PIP-TZ, from July 2017 to July 2018, in a general hospital in the countryside of Rio Grande do Sul. Results: 33% of antimicrobial resistance (RA) to PIP-TZ was found; the empirical prescriptions represented almost 95% of the cases; 16% of the patients had no material obtained for microbiological culture. The analysis on the length of hospital stay shows a clear relationship with the days elapsed between the culture result / TSA and the appropriate treatment adjustment, because when this measure was adopted on day 1, the mean length of hospitalization was 14 days, rising to 25 days when treatment was adjusted from day 6 onwards. Discussion: This study describes a high rate of use of broad spectrum antimicrobials and a long time to adjust therapies, which reflects an increase in the length of hospital stay and high rates of bacterial resistance. This study reaffirms the need for medical education permanent and active action of the CCIH, aiming at the more judicious use of broad spectrum antimicrobials and seeking the optimization of clinical and cost indicators.