title: [Prudent use of antibiotics and suggestions for improvement from hospital-based medicine].
abstract: The largest consumption of antimicrobials is concentrated in hospitals and within them, the intensive care units. The quality of antimicrobial use is not optimal, with up to 50% of prescriptions being unnecessary or inappropriate. Inappropriate antibiotic use leads to severe consequences, such as increased patient mortality and morbidity and bacterial resistance. The primary reason for inappropriate use is the insufficient knowledge of the increasingly vast and complex information about the diagnosis and treatment of infectious diseases. There is general agreement on the need to improve the use of antimicrobials in hospitals but not on how to improve it. University Hospital Virgen del Rocío (Seville) has launched the Institutional Programme for the Optimisation of Antimicrobial Treatment (PRIOAM), inspired by the recommendations of the Infectious Diseases Society of America and adapted to the structural, functional and cultural characteristics of the hospital. PRIOAM is coordinated by a multidisciplinary team chosen by the Committee on Infections and Antimicrobials and has three basic characteristics: it is an institutional programme that has incentives linked to achieving goals; it is an educational programme in which training and knowledge are the basis for the proper use of antimicrobials; and it is a programme subject to results, in which the main objectives are clinical, not economic, to reduce mortality and morbidity in patients with infections and to delay the development of resistance.
authors: Unidad Clínica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS), Sevilla, España. cisnerosjm@telefonica.net
authors: José Miguel
authors: JM
authors: Cisneros
authors: Carlos
authors: C
authors: Ortiz-Leyba
authors: José Antonio
authors: JA
authors: Lepe
authors: Ignacio
authors: I
authors: Obando
authors: Manuel
authors: M
authors: Conde
authors: Aurelio
authors: A
authors: Cayuela
authors: María Victoria
authors: MV
authors: Gil
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D024881:Drug Resistance, Bacterial; D004363:Drug Utilization / Q000592:standards / Q000706:statistics & numerical data; D006761:Hospitals; D006801:Humans; D017410:Practice Guidelines as Topic
chemical_list: D000900:Anti-Bacterial Agents