title: Impact of an intervention in the use of sequential antibiotic therapy in a Brazilian university hospital.
abstract: BACKGROUND
  Sequential antibiotic therapy (SAT) is safe and economical. However, the unnecessary use of intravenous (IV) administration usually occurs. The objective of this work was to get to know the effectiveness of an intervention to implement the SAT in a teaching hospital in Brazil.
  
  
  METHODS
  This was a prospective and interventional study, historically controlled, and was conducted in the Hospital de Clínicas, Universidade Federal de Uberlândia, State of Minas Gerais, Brazil, a high complexity teaching hospital having 503 beds. In each of the periods, from 04/04/05 to 07/20/05 (pre-intervention) and from 09/24/07 to 12/20/07 (intervention), 117 patients were evaluated. After the pre-intervention period, guidelines were developed which were implemented during the intervention period along with educational measures and a reminder system added to the patients' prescription.
  
  
  RESULTS
  In the pre-intervention and intervention periods, the IV antibiotics were used as treatment for a average time of 14.8 and 11.8 days, respectively. Ceftriaxone was the antibiotic most prescribed in both periods (23.4% and 21.6% respectively). Starting from the first prescription of antibiotics, the average length of hospitalization time was 21.8 and 17.5 days, respectively. The SAT occurred only in 4 and 5 courses of treatment, respectively, and 12.8% and 18.8% of the patients died in the respective periods.
  
  
  CONCLUSIONS
  Under the presented conditions, the evaluated intervention strategy is ineffective in promoting the exchange of the antibiotic administration from IV to oral treatment (SAT).
authors.affiliation: Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Uberlândia. Uberlândia, MG, Brasil.
authors.forename: Raquel Melo
authors.initials: RM
authors.lastname: Rodrigues
authors.forename: Astrídia Marília de Souza
authors.initials: AM
authors.lastname: Fontes
authors.forename: Orlando César
authors.initials: OC
authors.lastname: Mantese
authors.forename: Renata Souza
authors.initials: RS
authors.lastname: Martins
authors.forename: Miguel Tanús
authors.initials: MT
authors.lastname: Jorge
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001938:Brazil; D005260:Female; D006785:Hospitals, University / Q000706:statistics & numerical data*; D006801:Humans; D007262:Infusions, Intravenous / Q000706:statistics & numerical data; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D019564:Unnecessary Procedures / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents