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      Monitoring of the antibiotic prescriptions in order to prevent microbial resistance in the intensive care unit in the Russian hospital

      abstract
      1 , 2 , 1 , 1 , 1 , 3
      Critical Care
      BioMed Central
      25th International Symposium on Intensive Care and Emergency Medicine
      21-25 March 2005

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          Abstract

          Background This presentation shows how, at the City Hospital, it was possible to improve the quality of clinical practice in surgery departments and ICUs. Introduction Antibiotics play an important role in clinical practice. The expenditure on these drugs is more than 50% of the total expenditure for drugs at the hospital. Uncontrolled use of antibiotics, in the environment of intolerably poor financing of the hospitals in Russia, and the absence of adequate control of the antibiotic prescriptions induce the growth of resistance in the hospital microbial flora, and as a result the expenditure on drug treatment increases. Methodology An analysis of the antibiotics purchased by the administration of the hospital was made in order to determine the baseline proportions of the different classes of antibiotics in the total structure in the year 2003. The analysis showed a high percentage of beta-lactams in the structure of the antibiotics purchased (88%). The data from the Diagnostic Laboratory Center of the city were impressive: the level of Klebsiella pneumoniae producing the enlarged-spectrum beta-lactamases reached a level of 92.5% in the ICU. An analysis of patients' data at the ICU and surgical departments (in a cohort of 300) was made in order to evaluate the quality and appropriateness of the antibiotic prescriptions. An inappropriate choice of antibiotics, wrong dosage, or an incorrect timing regime were revealed in 60% of cases. The protocols of antibiotic prophylaxis and the strict rules of antibiotic prescriptions in the ICU, prepared according to the data of evidence-based medicine, were implemented. Conclusion The system of governance of antibiotic prescriptions, the monitoring of the microbial resistance in the ICU, and the strict adherence to the protocols of antibiotic usage have gained approval and enabled an improvement in the quality of treatment (from 60% to 30%) and a reduction of the expenditure for antibiotics (40%).

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          Author and article information

          Conference
          Crit Care
          Crit Care
          Critical Care
          BioMed Central
          1364-8535
          1466-609X
          2005
          7 March 2005
          : 9
          : Suppl 1
          : P23
          Affiliations
          [1 ]Clinical Hospital N40, Yekaterinburg, Russia
          [2 ]UMIST, Manchester, UK
          [3 ]Center of Laboratory Diagnostics of Diseases of Mother and Child, Yekaterinburg, Russia
          Article
          cc3086
          10.1186/cc3086
          4098173
          6867993e-25dd-4521-9082-a0081b462dda
          Copyright © 2005 BioMed Central Ltd
          25th International Symposium on Intensive Care and Emergency Medicine
          Brussels, Belgium
          21-25 March 2005
          History
          Categories
          Poster Presentation

          Emergency medicine & Trauma
          Emergency medicine & Trauma

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