School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, PR, Brazil.
Laboratory of Emerging Infectious Diseases, Escola de Medicina, Pontifícia Universidade Católica do Paraná, Rua Imaculada Conceição, 1155, Curitiba, PR, 80215-901, Brazil.
BMC Infect Dis. 2019 Jul 22;19(1):650. doi: 10.1186/s12879-019-4280-0.
This study aimed to evaluate the oral switch (OS) stewardship intervention in the intensive care unit (ICU).
This was a retrospective study with a convenience sample in two Brazilian ICUs from different hospitals in patients with sepsis receiving antibiotic therapy. The stewardship intervention included OS in patients diagnosed with sepsis when clinical stability was achieved. The primary outcome was overall mortality. Other variables evaluated were as follows: cost of antimicrobial treatment, daily costs of intensive care, acute kidney injury, and length of stay.
There was no difference in mortality between the OS and non-OS groups (p = 0.06). Length of stay in the ICU (p = 0.029) was shorter and acute kidney injury incidence (p = 0.032) and costs of antimicrobial therapy (p < 0.001) were lower in the OS group.
OS stewardship programs in the ICU may be considered a safe strategy. Switch therapy reduced the cost and shortened the length of stay in ICUs.
本研究旨在评估重症监护病房（ICU）中的口服转换（OS）管理干预措施。
这是一项回顾性研究，采用便利抽样法，选取了来自巴西两家不同医院的 ICU 中接受抗生素治疗的脓毒症患者。管理干预措施包括在临床稳定时诊断为脓毒症的患者中进行 OS。主要结局为总体死亡率。评估的其他变量如下：抗菌治疗的成本、重症监护的日费用、急性肾损伤和住院时间。
OS 组和非 OS 组之间的死亡率无差异（p=0.06）。OS 组 ICU 住院时间（p=0.029）更短，急性肾损伤发生率（p=0.032）和抗菌治疗费用（p<0.001）更低。
ICU 中的 OS 管理计划可能被认为是一种安全的策略。转换治疗降低了 ICU 的成本并缩短了住院时间。
