| Abstract [eng] |
In most hospitals, the treatment of intensive care unit patients is inseparable from antibacterial therapy. Early empirical antibiotic therapy is essential, but inappropriate prescribing may be associated with increased antibiotic resistance and significant challenges in infection control. The study was conducted to assess the practice of antibacterial therapy for sepsis patients at the Vilnius University Hospital Santaros Clinics Intensive Care centre, compare the results with the hospital's empirical antibiotic therapy guidelines, and review the literature on adequate antibacterial therapy, de-escalation, and antibiotic stewardship. The analysed data was collected from the period of 1 January 2019 to 1 February 2020. In total, 100 patients were included. The antibiotics were classified into three groups: Access, Watch, and Reserve according to the World Health Organization's recommended AWaRe classification. The study revealed that empirical therapy with Watch group antibiotics was selected in 52.0% of the cases, the Access group antibiotics were prescribed for 24.0% of the cases, and the rest of the cases received combined treatment with several different classes of antibiotics. Microbiological cultures were obtained in 99 out of 100 patients. Of the 99 patients, antibiotic therapy was de-escalated only for 9.1% of the cases, 40.4% could not be de-escalated, and 50.5% were not de-escalated, even though the culture results showed that de-escalation was possible. Therefore, the clinical audit of antimicrobial therapy helped to identify the potential improvements in the antibiotic de-escalation process and adequate antibacterial therapy use in the hospital. Implementation of the antibiotic stewardship program discussed in the literature review would benefit clinical practice in intensive care units and reduce the risk of multidrug-resistant infections. |
