title: [Programs for optimizing the use of antibiotics (PROA) in Spanish hospitals: GEIH-SEIMC, SEFH and SEMPSPH consensus document].
abstract: The antimicrobial agents are unique drugs for several reasons. First, their efficacy is higher than other drugs in terms of reduction of morbidity and mortality. Also, antibiotics are the only group of drugs associated with ecological effects, because their administration may contribute to the emergence and spread of microbial resistance. Finally, they are used by almost all medical specialties. Appropriate use of antimicrobials is very complex because of the important advances in the management of infectious diseases and the spread of antibiotic resistance. Thus, the implementation of programs for optimizing the use of antibiotics in hospitals (called PROA in this document) is necessary. This consensus document defines the objectives of the PROA (namely, to improve the clinical results of patients with infections, to minimise the adverse events associated to the use of antimicrobials including the emergence and spread of antibiotic resistance, and to ensure the use of the most cost-efficacious treatments), and provides recommendations for the implementation of these programs in Spanish hospitals. The key aspects of the recommendations are as follows. Multidisciplinary antibiotic teams should be formed, under the auspices of the Infection Committees. The PROA need to be considered as part of institutional programs and the strategic objectives of the hospital. The PROA should include specific objectives based on measurable indicators, and activities aimed at improving the use of antimicrobials, mainly through educational activities and interventions based more on training activities directed to prescribers than just on restrictive measures.
authors.affiliation: Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario Virgen Macarena, Departamento de Medicina, Universidad de Sevilla, Sevilla, España. jesusrb@us.es
authors.forename: Jesús
authors.initials: J
authors.lastname: Rodríguez-Baño
authors.forename: José Ramón
authors.initials: JR
authors.lastname: Paño-Pardo
authors.forename: Luis
authors.initials: L
authors.lastname: Alvarez-Rocha
authors.forename: Angel
authors.initials: A
authors.lastname: Asensio
authors.forename: Esther
authors.initials: E
authors.lastname: Calbo
authors.forename: Emilia
authors.initials: E
authors.lastname: Cercenado
authors.forename: José Miguel
authors.initials: JM
authors.lastname: Cisneros
authors.forename: Javier
authors.initials: J
authors.lastname: Cobo
authors.forename: Olga
authors.initials: O
authors.lastname: Delgado
authors.forename: José
authors.initials: J
authors.lastname: Garnacho-Montero
authors.forename: Santiago
authors.initials: S
authors.lastname: Grau
authors.forename: Juan Pablo
authors.initials: JP
authors.lastname: Horcajada
authors.forename: Ana
authors.initials: A
authors.lastname: Hornero
authors.forename: Javier
authors.initials: J
authors.lastname: Murillas-Angoiti
authors.forename: Antonio
authors.initials: A
authors.lastname: Oliver
authors.forename: Belén
authors.initials: B
authors.lastname: Padilla
authors.forename: Juan
authors.initials: J
authors.lastname: Pasquau
authors.forename: Miquel
authors.initials: M
authors.lastname: Pujol
authors.forename: Patricia
authors.initials: P
authors.lastname: Ruiz-Garbajosa
authors.forename: Rafael
authors.initials: R
authors.lastname: San Juan
authors.forename: Rafael
authors.initials: R
authors.lastname: Sierra
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D004363:Drug Utilization / Q000592:standards*; D006761:Hospitals; D006801:Humans; D008485:Medical Audit; D019984:Quality Indicators, Health Care; D013030:Spain
chemical_list: D000900:Anti-Bacterial Agents