L García-López1, S Grau-Cerrato2, A de Frutos-Soto1, F Bobillo-De Lamo3, R Cítores-Gónzalez3, F Diez-Gutierrez3, M F Muñoz-Moreno4, T Sánchez-Sánchez1, F Gandía-Martínez3, D Andaluz-Ojeda5. 1. Servicio de Farmacia, Hospital Clínico Universitario de Valladolid, Valladolid, España. 2. Servicio de Farmacia, Hospital del Mar, Barcelona, España. 3. Unidad de Cuidados Intensivos, Hospital Clínico Universitario de Valladolid, Valladolid, España. 4. Sección de Metodología y Bioestadística, Hospital Clínico Universitario de Valladolid, Valladolid, España. 5. Unidad de Cuidados Intensivos, Hospital Clínico Universitario de Valladolid, Valladolid, España. Electronic address: dandaluz@saludcastillayleon.es.
Abstract
INTRODUCTION: A study was performed to analyze the impact of an in-hospital Sepsis Code (SC) program on use of antibiotic and clinical outcomes. DESIGN: Quasi-experimental observational retrospective study. SETTING: Polyvalent 11 beds ICU belonging to a tertiary Universitary hospital. PATIENTS: Patients admitted consecutively to the ICU with diagnosis of severe sepsis or septic shock. INTERVENTIONS: A post intervention group (POST-SC) (September 2012-August 2013) was compared with a historical group (PRE-SC) used as control (January-December 2010). VARIABLES: Antibiotic treatment, therapeutic antibiotic strategy, mortality and length of stay. Antibiotic consumption was expressed as defined daily doses (DDD)/ 100 stays. RESULTS: 42 patients with SS/SS in POST-SC group and 50 patients in PRE-SC group were consecutively recluted and further analyzed. Total antibiotic consumption (DDD) was similar in both groups. Rate of de-escalation therapy was significantly higher in POST-SC group (75% vs 30,8%, p<0,005) while prescription of restricted antibiotics was significantly lower (74% vs 52%, p=0,031). Finally POST-SC patients showed a significantly decrease in hospital and 28 days mortality rates [23% vs 44%, (p=0,035) and 31% vs 56% (p=0,014) respectively] as well as a reduction in ICU length of stay compared to PRE-SC cohort (5 days vs 10,5 days, p=0,05). CONCLUSION: The implementation of a Sepsis Code-hospital protocol is associated to an improvement in the management of antibiotic therapy with a significant increase in de-escalation therapy and lesser utilization of restricted use antibiotics, as well as a significant reduction in mortality, and a tendency towards shorter ICU length stay.
INTRODUCTION: A study was performed to analyze the impact of an in-hospital Sepsis Code (SC) program on use of antibiotic and clinical outcomes. DESIGN: Quasi-experimental observational retrospective study. SETTING: Polyvalent 11 beds ICU belonging to a tertiary Universitary hospital. PATIENTS: Patients admitted consecutively to the ICU with diagnosis of severe sepsis or septic shock. INTERVENTIONS: A post intervention group (POST-SC) (September 2012-August 2013) was compared with a historical group (PRE-SC) used as control (January-December 2010). VARIABLES: Antibiotic treatment, therapeutic antibiotic strategy, mortality and length of stay. Antibiotic consumption was expressed as defined daily doses (DDD)/ 100 stays. RESULTS: 42 patients with SS/SS in POST-SC group and 50 patients in PRE-SC group were consecutively recluted and further analyzed. Total antibiotic consumption (DDD) was similar in both groups. Rate of de-escalation therapy was significantly higher in POST-SC group (75% vs 30,8%, p<0,005) while prescription of restricted antibiotics was significantly lower (74% vs 52%, p=0,031). Finally POST-SC patients showed a significantly decrease in hospital and 28 days mortality rates [23% vs 44%, (p=0,035) and 31% vs 56% (p=0,014) respectively] as well as a reduction in ICU length of stay compared to PRE-SC cohort (5 days vs 10,5 days, p=0,05). CONCLUSION: The implementation of a Sepsis Code-hospital protocol is associated to an improvement in the management of antibiotic therapy with a significant increase in de-escalation therapy and lesser utilization of restricted use antibiotics, as well as a significant reduction in mortality, and a tendency towards shorter ICU length stay.
Authors: A Bautista Hernández; E de Vega-Ríos; J Serrano Ballesteros; D Useros Braña; L Cardeñoso Domingo; A Figuerola Tejerina; D Jiménez Jiménez; I de Los Santos Gil; C Sáez Béjar Journal: Rev Esp Quimioter Date: 2022-01-31 Impact factor: 1.553
Authors: F J Candel; M Borges Sá; S Belda; G Bou; J L Del Pozo; O Estrada; R Ferrer; J González Del Castillo; A Julián-Jiménez; I Martín-Loeches; E Maseda; M Matesanz; P Ramírez; J T Ramos; J Rello; B Suberviola; A Suárez de la Rica; P Vidal Journal: Rev Esp Quimioter Date: 2018-06-25 Impact factor: 1.553
Authors: F Llopis-Roca; R López Izquierdo; O Miro; J E García-Lamberechts; A Julián Jiménez; J González Del Castillo Journal: Rev Esp Quimioter Date: 2022-02-01 Impact factor: 1.553