%0 Journal Article
%A Sadyrbaeva-Dolgova, Svetlana
%A Aznarte-Padial, Pilar
%A Jimenez-Morales, Alberto
%A Exposito-Ruiz, Manuela
%A Calleja-Hernandez, Miguel Angel
%A Hidalgo-Tenorio, Carmen
%T Pharmacist recommendations for carbapenem de-escalation in urinary tract infection within an antimicrobial stewardship program.
%D 2019
%U http://hdl.handle.net/10668/14630
%X Carbapenem antibiotics are considered the treatment of choice for serious extended-spectrum beta-lactamase-producing Gram-negative bacteria infections. Our objectives were to analyze the results of carbapenem de-escalation therapy in complicated urinary tract infections (UTIs) attended in a third-level Spanish hospital and to evaluate the impact of pharmacist recommendation in this practice, the outcomes obtained, and associated factors. This prospective observational study of carbapenem prescriptions and de-escalation performance was conducted in a third-level hospital between August 1 2013 and July 31, 2014. Data were gathered on carbapenem treatment duration, de-escalation, length of hospital stay, mortality rate, and associated re-admissions. De-escalation, which was only ordered for patients with positive cultures, was conducted in 49.7% of the 163 patients with complicated UTI. More than half (69.1%) of pharmacist interventions were accepted. De-escalation reduced the median hospital stay by five days (p=0.030). Crude hospital mortality was lower in the de-escalation group (7.4% vs. 29.3%, p Carbapenem de-escalation in accordance with pharmacist recommendation proved to be a safe approach in complicated UTI, reducing the hospital stay of patients without affecting the re-admission rate.
%K Antimicrobial stewardship programs
%K Carbapenems
%K De-escalation
%K Pharmacist recommendations
%K Urinary tract infection
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