title: Resource-saving advice from an infectious diseases specialist team in a large university hospital: an exportable model?
abstract: OBJECTIVE
  To assess epidemiological features of patients for which a consultation by the infectious diseases consultation team was required, and the rate of clinical advice that led to resource-saving advice (R-SA): discontinuation of inappropriate therapy or prophylaxis, de-escalation and switch from parenteral to oral therapy.
  
  
  METHODS
  An infectious diseases consultation team was implemented in a 1100-bed university hospital in Italy.
  
  
  RESULTS
  The most frequent infections for which an infectious diseases consultancy was required were pneumonia, bloodstream infections (17% by Candida) and urinary tract infections. In 828 patients (41.4%), interventions with the possibility of R-SA were suggested.
  
  
  CONCLUSIONS
  Resource-saving advices were possible in 41% of cases. Recent surgery, having a central venous catheter, bloodstream, abdominal, surgical site or bone and joint infections were correlated to a higher probability of receiving R-SA.
authors.affiliation: Institute of Infectious Diseases, Risk Management Unit, Institute of Microbiology, Catholic University of Rome, Rome, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Fantoni
authors.forename: Rita
authors.initials: R
authors.lastname: Murri
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Scoppettuolo
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Fabbiani
authors.forename: Giulio
authors.initials: G
authors.lastname: Ventura
authors.forename: Raffaella
authors.initials: R
authors.lastname: Losito
authors.forename: Filippo
authors.initials: F
authors.lastname: Berloco
authors.forename: Teresa
authors.initials: T
authors.lastname: Spanu
authors.forename: Maurizio
authors.initials: M
authors.lastname: Sanguinetti
authors.forename: Roberto
authors.initials: R
authors.lastname: Cauda
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002177:Candidiasis / Q000188:drug therapy / Q000453:epidemiology; D003141:Communicable Diseases; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology*; D004363:Drug Utilization; D005260:Female; D006785:Hospitals, University / Q000191:economics*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D011014:Pneumonia / Q000188:drug therapy / Q000453:epidemiology; D012017:Referral and Consultation / Q000191:economics*; D012307:Risk Factors; D018805:Sepsis / Q000453:epidemiology; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents
keywords: antibiotic stewardship; bloodstream infections; infectious diseases