Sadyrbaeva-Dolgova, SvetlanaAznarte-Padial, PilarJimenez-Morales, AlbertoExposito-Ruiz, ManuelaCalleja-Hernandez, Miguel AngelHidalgo-Tenorio, Carmen2023-02-082023-02-082019-09-18Sadyrbaeva-Dolgova S, Aznarte-Padial P, Jimenez-Morales A, Expósito-Ruiz M, Calleja-Hernández MÁ, Hidalgo-Tenorio C. Pharmacist recommendations for carbapenem de-escalation in urinary tract infection within an antimicrobial stewardship program. J Infect Public Health. 2020 Apr;13(4):558-563.http://hdl.handle.net/10668/14630Carbapenem 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.enAttribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/Antimicrobial stewardship programsCarbapenemsDe-escalationPharmacist recommendationsUrinary tract infectionAgedAged, 80 and overAntimicrobial StewardshipCarbapenemsCross InfectionFemaleHumansLength of StayMaleMiddle AgedPharmacistsProspective StudiesUrinary Tract Infectionsresearch article31685404open accessAnciano de 80 o más añosCarbapenémicosInfecciones urinariasInfección hospitalariaPersona de mediana edadProgramas de optimización del uso de los antimicrobianosTiempo de internación10.1016/j.jiph.2019.09.0141876-035Xhttps://doi.org/10.1016/j.jiph.2019.09.014