Long term effects of de-escalation antimicrobial strategy in the burn unit
- Authors: Medvedev D.S.1, Bakulina N.V.2
-
Affiliations:
- City Pokrovskaya Hospital
- North-Western State Medical University named after I.I. Mechnikov
- Issue: Vol 14, No 4 (2022)
- Pages: 71-81
- Section: Original research
- URL: https://journals.rcsi.science/vszgmu/article/view/131115
- DOI: https://doi.org/10.17816/mechnikov111045
- ID: 131115
Cite item
Abstract
BACKGROUND: De-escalation strategy of antimicrobial therapy demonstrates favorable short-term results: it lowers the mortality and reduces the cost of treatment. The long-term results of applying this strategy in the burn unit had not been studied previously.
AIM: To compare the long-term results of the de-escalation approach to antimicrobial therapy on the microbial spectrum, resistance of the hospital microflora and consumption of antimicrobials in the burn unit.
MATERIALS AND METHODS: The study comprises the data from the burn unit of the Severstal hospital for 2006, 2012 and 2021: statistical data on mortality and the average duration of hospital stay; microbiological data on spectrum and resistance of bacteria to antimicrobials.
RESULTS: The use of the de-escalation strategy of antimicrobial therapy in the burn unit of the Healthcare Institution “Severstal” for 10 years has reduced mortality, length of stay, consumption of antimicrobials. De-escalation strategy has not significantly affect the spectrum of nosocomial microflora but has lowered the resistance of gram-positive microorganisms to antibiotics. There was a decrease in the drug resistance index for the main pathogens of infectious complications as a result of implementing the de-escalation strategy.
CONCLUSIONS: The implementation a de-escalation strategy of antimicrobial therapy requires conducting periodic microbiological monitoring for early correction of starting antimicrobial regimens.
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##article.viewOnOriginalSite##About the authors
Denis S. Medvedev
City Pokrovskaya Hospital
Author for correspondence.
Email: mds80@inbox.ru
ORCID iD: 0000-0002-1862-5418
SPIN-code: 8723-8915
ResearcherId: F-6015-2014
Russian Federation, Saint Petersburg
Natalia V. Bakulina
North-Western State Medical University named after I.I. Mechnikov
Email: natalya.bakulina@szgmu.ru
ORCID iD: 0000-0003-4075-4096
SPIN-code: 9503-8950
Scopus Author ID: 7201739080
ResearcherId: N-7299-2014
MD, Dr. Sci. (Med.), Assistant Professor
Russian Federation, Saint PetersburgReferences
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