title: Antimicrobial stewardship in patients recently transferred to a ward from the ICU.
abstract: OBJECTIVE
  Inappropriate use of antibiotics is an important health problem that is related to increasing bacterial resistance. Despite its relevance, many health institutions assign very limited resources to improving prescribing practices. An antimicrobial stewardship programme (APS) centred on patients discharged from the ICU could efficiently undertake this task.
  
  
  METHODS
  During this six month study the main activity was performing a programmed review of antimicrobial prescriptions in patients transferred to the ward from the ICU. In the case of inadequate antimicrobial treatment, a recommendation was included in the medical record.
  
  
  RESULTS
  A total of 437 antimicrobial prescriptions for 286 patients were revised during a six month period. In all, 271 prescriptions (62%) were considered inappropriate in 183 patients. The most common reasons for inappropriateness were treating unconfirmed infection (43%), inadequate antimicrobial coverage (34%) and intravenous administration when the oral route was feasible (11%). Proposed recommendations were addressed in 212 cases (78%). There was no significant difference in adherence with respect to the type of recommendation (p=0.417). There was a 5% lower use of antibiotics during the year the study was conducted compared to the previous one.
  
  
  CONCLUSIONS
  ASPs centred on patients discharged from the ICU may be an efficient strategy to ameliorate antimicrobial use in hospitals.
authors.affiliation: Antonio Ramos,Department of Internal Medicine (Infectious Diseases Unit). Hospital Universitario Puerta de Hierro. Universidad Autónoma de Madrid, Maestro Rodrigo nº 2. 28220 Majadahonda. Madrid. Spain. aramos220@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Ramos
authors.forename: L
authors.initials: L
authors.lastname: Benítez-Gutierrez
authors.forename: A
authors.initials: A
authors.lastname: Asensio
authors.forename: B
authors.initials: B
authors.lastname: Ruiz-Antorán
authors.forename: C
authors.initials: C
authors.lastname: Folguera
authors.forename: I
authors.initials: I
authors.lastname: Sánchez-Romero
authors.forename: E
authors.initials: E
authors.lastname: Muñez
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003422:Critical Care / Q000379:methods*; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004363:Drug Utilization; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D057970:Inappropriate Prescribing / Q000706:statistics & numerical data; D007362:Intensive Care Units / Q000458:organization & administration*; D008297:Male; D008875:Middle Aged; D010360:Patient Transfer; D013030:Spain
chemical_list: D000900:Anti-Bacterial Agents