IMPLEMENTATION OF ANTIMICROBIAL STEWARDSHIP PROGRAMS SOFTWARE APPLICATION
European Statement
Clinical Pharmacy Services
Author(s)
A. ALENTADO MATEU 1 , L. ALVAREZ ARROYO 1 , R. MARTINEZ GOZALBEZ 2 , O. PEREZ OLASO 3 , R. LIMÓN RAMIREZ 4, B. MONTAÑÉS PAULS 1 .
1 HOSPITAL UNIVERSITARIO LA PLANA, FARMACIA, VILA-REAL, ESPAÑA.
2 HOSPITAL UNIVERSITARIO LA PLANA, INFORMÁTICA, VILA-REAL, ESPAÑA.
3 HOSPITAL UNIVERSITARIO LA PLANA, MICROBIOLOGIA, VILA-REAL, ESPAÑA.
4 HOSPITAL UNIVERSITARIO LA PLANA, MEDICINA PREVENTIVA, VILA-REAL, ESPAÑA.
Why was it done?
For years, Antimicrobial Stewardship Programs (ASP) teams have been working to improve the quality of antimicrobial prescription by optimizing treatments, controlling bacteremia and managing infections caused by resistant or difficult to treat microorganisms.
It is essential to have a software tool that allows real-time monitoring of both treatments and certain cultures.
What was done?
The ASP team, in collaboration with the information technology unit designed, developed and implemented a computer application at our center to support the ASP team. This application screens inpatients, searching for any of the predefined parameter alerts based on the type of antibiotic prescribed, the microorganism causing the infection, positive blood cultures or patients who are difficult to manage.
How was it done?
This alert system is based on the integration of the various hospital clinical information systems. Admitted patients are selected after a medical prescription of certain predefined antibiotics (carbapenems, daptomycin, linezolid, piperacillin/tazobactam, ceftazidime/avibactam, etc); these data are obtained from the electronic prescription programme (Athos-Prisma®). Microbiological criteria (Gestlab@ programme) include multi-resistant microorganisms (Escherichia coli, Methicillin-resistant Staphylococcus aureus), positive blood cultures, Pseudomonas, etc. Based on clinical criteria, patients who are difficult to manage can be manually included in the computer programme, mainly by the internal medicine and intensive care unit departments. The antimicrobial and microbiological criteria are dynamic and can be modified as needed.
What has been achieved?
From June 1 st 2023 to February 1 st 2024, 300 different patients have underwent interventions. In the patient’s electronic medical record from the ASP application, 355 ASP recommendations were made for 236 patients. ASP interventions included recommended isolation measures (242), modifying or suspending antibiotic treatment (68), maintaining adequate antibiotic treatment (22), initiating antibiotic treatment (11) and requesting complementary tests (12), such as imaging, cultures or serology.
What next?
This application is a fundamental communication tool for ASP teams allowings different recommendations for optimizing antimicrobial treatment to be made in the application. It automatically generates a note in the patient’s clinical history, making it accessible to all healthcare professionals and allowings for easy extrapolation to other hospitals, enabling its implementation in daily clinical practice.