Browsing by Autor "S Del Guerra"

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    Antimicrobial stewardship programs in adult intensive care units in Latin America: Implementation, assessments, and impact on outcomes
    (Cambridge University Press, 2021) Rodolfo Quirós; Ana C. Bardossy; Patricia Angeleri; Jeannete Zurita; Washington René Alemán Espinoza; Marcelo Carneiro; S Del Guerra; Julio C. Medina; Ximena Castañeda Luquerna; Alexander Guerra
    MS-ICUs with more comprehensive ASPs showed significant improvement in antimicrobial utilization.
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    Impact of Antimicrobial Stewardship Programs in Latin American Adult Intensive Care Units: PROA-LATAM Project
    (Cambridge University Press, 2020) Rodolfo Quirós; Patricia Angeleri; Jeannete Zurita; Washington Alemán; Marcelo Carneiro; S Del Guerra; Julio C. Medina; Ximena Castañda Luquerna; Alexander Guerra; Silvio Vega
    Background: Antimicrobial stewardship programs (ASPs) are useful in improving clinical outcomes in a cost-effective way and in reducing antimicrobial resistance. Objective: We sought to determine the impact of ASP in adult medical-surgical intensive care units (MS-ICUs). Methods: A multicenter study, in 77 MS-ICUs of 9 Latin-American countries, was conducted along 12 months (July 2018–June 2019). A self-assessment survey using a tool based on CDC recommendations (0–100 scale) was performed at the beginning, after 6 months, and at the end of the study. The impact of ASP was evaluated monthly using the following indicators: antimicrobial consumption (defined daily doses [DDD] per 100 patient days), appropriateness of antimicrobial prescriptions (percentage of total prescriptions), crude mortality rate (events per 100 discharges), and hospital-acquired multidrug-resistant microorganisms (MDRs) and Clostridioides difficile infections (CDI events per 1,000 patient days). These indicators were compared between MS-ICUs that reached the 75th percentile and those that maintained the 25th percentile at the final self-assessment. Results: Of all indicators evaluated, only surgical prophylaxis ≤24 hours, vancomycin therapeutic monitoring, and aminoglycosides (1 dose per day) did not show significant differences between MS-ICUs at the 75th percentile and the 25th percentile. CDI events were significantly higher at the 75th percentile MS-ICUs, probably related to better detection of C. difficile (Table 1). Conclusions: This study confirmed that MS-ICUs with more comprehensive ASPs had significantly better indicators. Funding: Proprietary Organization: MERCK Disclosures: None