title: Antimicrobial stewardship through telemedicine in a community hospital in Southern Brazil.
abstract: We developed an antimicrobial stewardship programme, based on telemedicine, for a remote community hospital in southern Brazil. Expertise in infectious diseases was provided from a 250-bed tertiary hospital for cardiology patients located 575 km away. At the community hospital, antimicrobial prescriptions were completed via a secure web site. A written reply was sent back to the prescriber by email and SMS text message. During a 4-month study period there were 81 prescriptions for 76 patients. Most antimicrobial prescriptions (67%) were for respiratory infections. Ampicillin was prescribed in 44% of cases (n = 56), gentamicin in 18% of cases (n = 23) and azithromycin in 18% of cases (n = 23). Two infectious diseases specialists independently reviewed each antimicrobial prescription. A total of 41 prescriptions (55%) were considered inappropriate. The median time to obtain a second opinion via the web site was 22 min (interquartile range 12-55). Overall compliance with the recommendations of the infectious diseases specialist was 100% (81 out of 81 requests). Telemedicine appears to have a useful potential role in antimicrobial stewardship programmes.
authors: Infection Control Committee, Instituto de Cardiologia do Rio Grande do Sul. Porto Alegre, Brazil. rpsrodrigo@gmail.com
authors: Rodrigo Pires
authors: RP
authors: dos Santos
authors: Caroline
authors: C
authors: Deutschendorf
authors: Otavio Fontoura
authors: OF
authors: Carvalho
authors: Robert
authors: R
authors: Timm
authors: Adolfo
authors: A
authors: Sparenberg
mesh_terms: D000328:Adult; D000368:Aged; D000890:Anti-Infective Agents / Q000008:administration & dosage*; D001938:Brazil; D011307:Drug Prescriptions / Q000592:standards*; D024881:Drug Resistance, Bacterial; D017723:Drug Utilization Review / Q000458:organization & administration*; D005240:Feasibility Studies; D005260:Female; D006764:Hospitals, Community; D006801:Humans; D008297:Male; D008875:Middle Aged; D015397:Program Evaluation; D017216:Telemedicine
chemical_list: D000890:Anti-Infective Agents