Review of antibiotic drug use in a surgical ICU: Management with a patient data management system for additional outcome analysis in patients staying more than 24 hours
Background: A number of developments have been made in computerized patient data management systems (PDMSs), making them of interest to medical and nursing staff as a means of improving patient care. Objectives: The aim of this study was to assess the capability of a PDMS to record and provide drug-...
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| Veröffentlicht in: | Clinical therapeutics 2004-06, Vol.26 (6), p.915-924 |
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| creator | Hartmann, Bernd Junger, Axel Brammen, Dominik Röhrig, Rainer Klasen, Joachim Quinzio, Lorenzo Benson, Matthias Hempelmann, Gunter |
| description | Background: A number of developments have been made in computerized patient data management systems (PDMSs), making them of interest to medical and nursing staff as a means of improving patient care.
Objectives: The aim of this study was to assess the capability of a PDMS to record and provide drug-administration data and to investigate whether the PDMS may be used as a means of support for clinical audits and quality control. Furthermore, we assessed whether antibiotic therapy as a surrogate for infections correlates with hospital mortality in patients staying >24 hours in a surgical intensive care unit (SICU).
Methods: Because of its medical and economic importance in ICU treatment, we chose to use the field of antibiotic therapy as an example. A PDMS was used in a 14-bed SICU (Department of Anesthesiology, Intensive Care Medicine, and Pain Therapy, University Hospital Giessen, Giessen, Germany) to record relevant patient data, including therapeutic, diagnostic, and nursing actions. During a 15-month period (April 1, 2000 to June 30, 2001), antibiotic drug therapy was electronically analyzed and presented using the anatomic therapeutic chemical (ATC) category for antibacterials (ATC group, J01) with daily defined doses. Furthermore, the correlation of antibiotic therapy with patient outcome (hospital mortality) was tested using logistic regression analysis.
Results: A total of 2053 patients were treated in the SICU. Of these, 58.0% (1190 patients) received antibiotics (4479 treatment days; 13,145 single doses). Cephalosporins (ATC category, J01DA) were used most frequently (1785 treatment days [39.9% of treatment days]), followed by combinations of penicillins with beta-lactam inhibitors (ATC category, J01CR; 1478 treatment days [33.0%]) and imidazole derivatives (ATC category, J01XD; 667 treatment days [14.9%]). The antibiotic therapy lasted 1 week. A total of 36.7% of cases were treated with only 1 antibiotic agent, 14.1% were given a combination of 2, and 7.2% were given a combination of ≥3 antibiotic agents. Seven hundred twenty-six patients remained in the SICU for >24 hours; 143 (19.7%) died during their hospital stay; 110 (15.2%) in the SICU. The duration of antibiotic therapy (odds ratio [OR], 1.46) and number of different antibiotic drugs used (OR, 2.15) significantly correlated with hospital mortality.
Conclusions: Antibiotic therapy in a SICU can be assessed and analyzed in de |
| doi_str_mv | 10.1016/S0149-2918(04)90135-X |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_66720494</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S014929180490135X</els_id><sourcerecordid>66720494</sourcerecordid><originalsourceid>FETCH-LOGICAL-c441t-6e36a3c146a5a0bab9e723386d34bc8e9238bb3ab7061b4656723a9a2ee023383</originalsourceid><addsrcrecordid>eNqFkc2KFDEUhYMoTjv6CEpAEF2U5q_SFTcijT8DI4I60LtwK3W7O0NVpU1SDv1GPqap6cYBN65CuN85NzmHkKecveaM6zffGVemEoY3L5l6ZRiXdbW-Rxa8WZqKc7W-TxZ_kTPyKKVrxpg0tXhIzngttFBaLMjvb_jL4w0NGwpj9q0P2TvaxWlLp4TUjxRomuLWO-jpxerqLf0CI2xxwDHTG593Zb6H7OdrBxnocDdOh5RxoJsQKXSdzz6MxSRM2YUByzroD8mnecfJIdGU4eDHLR1CRJp3MFKh6C5MMT0mDzbQJ3xyOs_J1ccPP1afq8uvny5W7y8rpxTPlUapQTquNNTAWmgNLoWUje6kal2DRsimbSW0S6Z5q3StyxgMCEQ2c_KcvDj67mP4OWHKdvDJYd_DiGFKVhcBU0YV8Pk_4HV5Z_lUspzJkropCReqPlIuhpQibuw--gHioUB2LtLeFmnnlixT9rZIuy66Zyf3qR2wu1OdmivAuyOAJYxSYbTJlQwddj6iy7YL_j8r_gCC5K8_</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1032919246</pqid></control><display><type>article</type><title>Review of antibiotic drug use in a surgical ICU: Management with a patient data management system for additional outcome analysis in patients staying more than 24 hours</title><source>MEDLINE</source><source>Access via ScienceDirect (Elsevier)</source><source>ProQuest Central UK/Ireland</source><creator>Hartmann, Bernd ; Junger, Axel ; Brammen, Dominik ; Röhrig, Rainer ; Klasen, Joachim ; Quinzio, Lorenzo ; Benson, Matthias ; Hempelmann, Gunter</creator><creatorcontrib>Hartmann, Bernd ; Junger, Axel ; Brammen, Dominik ; Röhrig, Rainer ; Klasen, Joachim ; Quinzio, Lorenzo ; Benson, Matthias ; Hempelmann, Gunter</creatorcontrib><description>Background: A number of developments have been made in computerized patient data management systems (PDMSs), making them of interest to medical and nursing staff as a means of improving patient care.
Objectives: The aim of this study was to assess the capability of a PDMS to record and provide drug-administration data and to investigate whether the PDMS may be used as a means of support for clinical audits and quality control. Furthermore, we assessed whether antibiotic therapy as a surrogate for infections correlates with hospital mortality in patients staying >24 hours in a surgical intensive care unit (SICU).
Methods: Because of its medical and economic importance in ICU treatment, we chose to use the field of antibiotic therapy as an example. A PDMS was used in a 14-bed SICU (Department of Anesthesiology, Intensive Care Medicine, and Pain Therapy, University Hospital Giessen, Giessen, Germany) to record relevant patient data, including therapeutic, diagnostic, and nursing actions. During a 15-month period (April 1, 2000 to June 30, 2001), antibiotic drug therapy was electronically analyzed and presented using the anatomic therapeutic chemical (ATC) category for antibacterials (ATC group, J01) with daily defined doses. Furthermore, the correlation of antibiotic therapy with patient outcome (hospital mortality) was tested using logistic regression analysis.
Results: A total of 2053 patients were treated in the SICU. Of these, 58.0% (1190 patients) received antibiotics (4479 treatment days; 13,145 single doses). Cephalosporins (ATC category, J01DA) were used most frequently (1785 treatment days [39.9% of treatment days]), followed by combinations of penicillins with beta-lactam inhibitors (ATC category, J01CR; 1478 treatment days [33.0%]) and imidazole derivatives (ATC category, J01XD; 667 treatment days [14.9%]). The antibiotic therapy lasted <3 days in 65.6% of cases. In 13.8% of cases, the treatment lasted >1 week. A total of 36.7% of cases were treated with only 1 antibiotic agent, 14.1% were given a combination of 2, and 7.2% were given a combination of ≥3 antibiotic agents. Seven hundred twenty-six patients remained in the SICU for >24 hours; 143 (19.7%) died during their hospital stay; 110 (15.2%) in the SICU. The duration of antibiotic therapy (odds ratio [OR], 1.46) and number of different antibiotic drugs used (OR, 2.15) significantly correlated with hospital mortality.
Conclusions: Antibiotic therapy in a SICU can be assessed and analyzed in detail using a PDMS. Furthermore, in this study, the duration of antibiotic therapy and the number of antibiotic agents used correlated with hospital mortality. In further developing PDMSs, it is important for quality-assurance purposes to document the reasons for giving antibiotics and for changing prescriptions. It would also be helpful to integrate certain therapy standards and reminder functions for the duration of therapy in the PDMS.</description><identifier>ISSN: 0149-2918</identifier><identifier>EISSN: 1879-114X</identifier><identifier>DOI: 10.1016/S0149-2918(04)90135-X</identifier><identifier>PMID: 15262462</identifier><language>eng</language><publisher>United States: EM Inc USA</publisher><subject>Adult ; Anti-Bacterial Agents - classification ; Anti-Bacterial Agents - therapeutic use ; antibiotics ; Bacterial Infections - drug therapy ; Bacterial Infections - mortality ; Bacterial Infections - prevention & control ; computerized patient record ; critical care ; drug therapy ; Drug Utilization Review - statistics & numerical data ; Female ; Germany - epidemiology ; Hospital Information Systems ; Hospital Mortality ; Hospitals, University - standards ; Humans ; intensive care ; Intensive Care Units - standards ; Length of Stay - statistics & numerical data ; Logistic Models ; Male ; Medical Records Systems, Computerized ; Odds Ratio ; Outcome and Process Assessment (Health Care) - statistics & numerical data ; ROC Curve ; Surgical Procedures, Operative - mortality ; Surgical Procedures, Operative - standards ; Surgical Wound Infection - drug therapy ; Surgical Wound Infection - mortality ; Surgical Wound Infection - prevention & control ; Treatment Outcome</subject><ispartof>Clinical therapeutics, 2004-06, Vol.26 (6), p.915-924</ispartof><rights>2004</rights><rights>Copyright Elsevier Limited Jun 2004</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c441t-6e36a3c146a5a0bab9e723386d34bc8e9238bb3ab7061b4656723a9a2ee023383</citedby><cites>FETCH-LOGICAL-c441t-6e36a3c146a5a0bab9e723386d34bc8e9238bb3ab7061b4656723a9a2ee023383</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1032919246?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15262462$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hartmann, Bernd</creatorcontrib><creatorcontrib>Junger, Axel</creatorcontrib><creatorcontrib>Brammen, Dominik</creatorcontrib><creatorcontrib>Röhrig, Rainer</creatorcontrib><creatorcontrib>Klasen, Joachim</creatorcontrib><creatorcontrib>Quinzio, Lorenzo</creatorcontrib><creatorcontrib>Benson, Matthias</creatorcontrib><creatorcontrib>Hempelmann, Gunter</creatorcontrib><title>Review of antibiotic drug use in a surgical ICU: Management with a patient data management system for additional outcome analysis in patients staying more than 24 hours</title><title>Clinical therapeutics</title><addtitle>Clin Ther</addtitle><description>Background: A number of developments have been made in computerized patient data management systems (PDMSs), making them of interest to medical and nursing staff as a means of improving patient care.
Objectives: The aim of this study was to assess the capability of a PDMS to record and provide drug-administration data and to investigate whether the PDMS may be used as a means of support for clinical audits and quality control. Furthermore, we assessed whether antibiotic therapy as a surrogate for infections correlates with hospital mortality in patients staying >24 hours in a surgical intensive care unit (SICU).
Methods: Because of its medical and economic importance in ICU treatment, we chose to use the field of antibiotic therapy as an example. A PDMS was used in a 14-bed SICU (Department of Anesthesiology, Intensive Care Medicine, and Pain Therapy, University Hospital Giessen, Giessen, Germany) to record relevant patient data, including therapeutic, diagnostic, and nursing actions. During a 15-month period (April 1, 2000 to June 30, 2001), antibiotic drug therapy was electronically analyzed and presented using the anatomic therapeutic chemical (ATC) category for antibacterials (ATC group, J01) with daily defined doses. Furthermore, the correlation of antibiotic therapy with patient outcome (hospital mortality) was tested using logistic regression analysis.
Results: A total of 2053 patients were treated in the SICU. Of these, 58.0% (1190 patients) received antibiotics (4479 treatment days; 13,145 single doses). Cephalosporins (ATC category, J01DA) were used most frequently (1785 treatment days [39.9% of treatment days]), followed by combinations of penicillins with beta-lactam inhibitors (ATC category, J01CR; 1478 treatment days [33.0%]) and imidazole derivatives (ATC category, J01XD; 667 treatment days [14.9%]). The antibiotic therapy lasted <3 days in 65.6% of cases. In 13.8% of cases, the treatment lasted >1 week. A total of 36.7% of cases were treated with only 1 antibiotic agent, 14.1% were given a combination of 2, and 7.2% were given a combination of ≥3 antibiotic agents. Seven hundred twenty-six patients remained in the SICU for >24 hours; 143 (19.7%) died during their hospital stay; 110 (15.2%) in the SICU. The duration of antibiotic therapy (odds ratio [OR], 1.46) and number of different antibiotic drugs used (OR, 2.15) significantly correlated with hospital mortality.
Conclusions: Antibiotic therapy in a SICU can be assessed and analyzed in detail using a PDMS. Furthermore, in this study, the duration of antibiotic therapy and the number of antibiotic agents used correlated with hospital mortality. In further developing PDMSs, it is important for quality-assurance purposes to document the reasons for giving antibiotics and for changing prescriptions. It would also be helpful to integrate certain therapy standards and reminder functions for the duration of therapy in the PDMS.</description><subject>Adult</subject><subject>Anti-Bacterial Agents - classification</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>antibiotics</subject><subject>Bacterial Infections - drug therapy</subject><subject>Bacterial Infections - mortality</subject><subject>Bacterial Infections - prevention & control</subject><subject>computerized patient record</subject><subject>critical care</subject><subject>drug therapy</subject><subject>Drug Utilization Review - statistics & numerical data</subject><subject>Female</subject><subject>Germany - epidemiology</subject><subject>Hospital Information Systems</subject><subject>Hospital Mortality</subject><subject>Hospitals, University - standards</subject><subject>Humans</subject><subject>intensive care</subject><subject>Intensive Care Units - standards</subject><subject>Length of Stay - statistics & numerical data</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Medical Records Systems, Computerized</subject><subject>Odds Ratio</subject><subject>Outcome and Process Assessment (Health Care) - statistics & numerical data</subject><subject>ROC Curve</subject><subject>Surgical Procedures, Operative - mortality</subject><subject>Surgical Procedures, Operative - standards</subject><subject>Surgical Wound Infection - drug therapy</subject><subject>Surgical Wound Infection - mortality</subject><subject>Surgical Wound Infection - prevention & control</subject><subject>Treatment Outcome</subject><issn>0149-2918</issn><issn>1879-114X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkc2KFDEUhYMoTjv6CEpAEF2U5q_SFTcijT8DI4I60LtwK3W7O0NVpU1SDv1GPqap6cYBN65CuN85NzmHkKecveaM6zffGVemEoY3L5l6ZRiXdbW-Rxa8WZqKc7W-TxZ_kTPyKKVrxpg0tXhIzngttFBaLMjvb_jL4w0NGwpj9q0P2TvaxWlLp4TUjxRomuLWO-jpxerqLf0CI2xxwDHTG593Zb6H7OdrBxnocDdOh5RxoJsQKXSdzz6MxSRM2YUByzroD8mnecfJIdGU4eDHLR1CRJp3MFKh6C5MMT0mDzbQJ3xyOs_J1ccPP1afq8uvny5W7y8rpxTPlUapQTquNNTAWmgNLoWUje6kal2DRsimbSW0S6Z5q3StyxgMCEQ2c_KcvDj67mP4OWHKdvDJYd_DiGFKVhcBU0YV8Pk_4HV5Z_lUspzJkropCReqPlIuhpQibuw--gHioUB2LtLeFmnnlixT9rZIuy66Zyf3qR2wu1OdmivAuyOAJYxSYbTJlQwddj6iy7YL_j8r_gCC5K8_</recordid><startdate>20040601</startdate><enddate>20040601</enddate><creator>Hartmann, Bernd</creator><creator>Junger, Axel</creator><creator>Brammen, Dominik</creator><creator>Röhrig, Rainer</creator><creator>Klasen, Joachim</creator><creator>Quinzio, Lorenzo</creator><creator>Benson, Matthias</creator><creator>Hempelmann, Gunter</creator><general>EM Inc USA</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>M7N</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20040601</creationdate><title>Review of antibiotic drug use in a surgical ICU: Management with a patient data management system for additional outcome analysis in patients staying more than 24 hours</title><author>Hartmann, Bernd ; Junger, Axel ; Brammen, Dominik ; Röhrig, Rainer ; Klasen, Joachim ; Quinzio, Lorenzo ; Benson, Matthias ; Hempelmann, Gunter</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c441t-6e36a3c146a5a0bab9e723386d34bc8e9238bb3ab7061b4656723a9a2ee023383</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Adult</topic><topic>Anti-Bacterial Agents - classification</topic><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>antibiotics</topic><topic>Bacterial Infections - drug therapy</topic><topic>Bacterial Infections - mortality</topic><topic>Bacterial Infections - prevention & control</topic><topic>computerized patient record</topic><topic>critical care</topic><topic>drug therapy</topic><topic>Drug Utilization Review - statistics & numerical data</topic><topic>Female</topic><topic>Germany - epidemiology</topic><topic>Hospital Information Systems</topic><topic>Hospital Mortality</topic><topic>Hospitals, University - standards</topic><topic>Humans</topic><topic>intensive care</topic><topic>Intensive Care Units - standards</topic><topic>Length of Stay - statistics & numerical data</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Medical Records Systems, Computerized</topic><topic>Odds Ratio</topic><topic>Outcome and Process Assessment (Health Care) - statistics & numerical data</topic><topic>ROC Curve</topic><topic>Surgical Procedures, Operative - mortality</topic><topic>Surgical Procedures, Operative - standards</topic><topic>Surgical Wound Infection - drug therapy</topic><topic>Surgical Wound Infection - mortality</topic><topic>Surgical Wound Infection - prevention & control</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hartmann, Bernd</creatorcontrib><creatorcontrib>Junger, Axel</creatorcontrib><creatorcontrib>Brammen, Dominik</creatorcontrib><creatorcontrib>Röhrig, Rainer</creatorcontrib><creatorcontrib>Klasen, Joachim</creatorcontrib><creatorcontrib>Quinzio, Lorenzo</creatorcontrib><creatorcontrib>Benson, Matthias</creatorcontrib><creatorcontrib>Hempelmann, Gunter</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical therapeutics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hartmann, Bernd</au><au>Junger, Axel</au><au>Brammen, Dominik</au><au>Röhrig, Rainer</au><au>Klasen, Joachim</au><au>Quinzio, Lorenzo</au><au>Benson, Matthias</au><au>Hempelmann, Gunter</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Review of antibiotic drug use in a surgical ICU: Management with a patient data management system for additional outcome analysis in patients staying more than 24 hours</atitle><jtitle>Clinical therapeutics</jtitle><addtitle>Clin Ther</addtitle><date>2004-06-01</date><risdate>2004</risdate><volume>26</volume><issue>6</issue><spage>915</spage><epage>924</epage><pages>915-924</pages><issn>0149-2918</issn><eissn>1879-114X</eissn><abstract>Background: A number of developments have been made in computerized patient data management systems (PDMSs), making them of interest to medical and nursing staff as a means of improving patient care.
Objectives: The aim of this study was to assess the capability of a PDMS to record and provide drug-administration data and to investigate whether the PDMS may be used as a means of support for clinical audits and quality control. Furthermore, we assessed whether antibiotic therapy as a surrogate for infections correlates with hospital mortality in patients staying >24 hours in a surgical intensive care unit (SICU).
Methods: Because of its medical and economic importance in ICU treatment, we chose to use the field of antibiotic therapy as an example. A PDMS was used in a 14-bed SICU (Department of Anesthesiology, Intensive Care Medicine, and Pain Therapy, University Hospital Giessen, Giessen, Germany) to record relevant patient data, including therapeutic, diagnostic, and nursing actions. During a 15-month period (April 1, 2000 to June 30, 2001), antibiotic drug therapy was electronically analyzed and presented using the anatomic therapeutic chemical (ATC) category for antibacterials (ATC group, J01) with daily defined doses. Furthermore, the correlation of antibiotic therapy with patient outcome (hospital mortality) was tested using logistic regression analysis.
Results: A total of 2053 patients were treated in the SICU. Of these, 58.0% (1190 patients) received antibiotics (4479 treatment days; 13,145 single doses). Cephalosporins (ATC category, J01DA) were used most frequently (1785 treatment days [39.9% of treatment days]), followed by combinations of penicillins with beta-lactam inhibitors (ATC category, J01CR; 1478 treatment days [33.0%]) and imidazole derivatives (ATC category, J01XD; 667 treatment days [14.9%]). The antibiotic therapy lasted <3 days in 65.6% of cases. In 13.8% of cases, the treatment lasted >1 week. A total of 36.7% of cases were treated with only 1 antibiotic agent, 14.1% were given a combination of 2, and 7.2% were given a combination of ≥3 antibiotic agents. Seven hundred twenty-six patients remained in the SICU for >24 hours; 143 (19.7%) died during their hospital stay; 110 (15.2%) in the SICU. The duration of antibiotic therapy (odds ratio [OR], 1.46) and number of different antibiotic drugs used (OR, 2.15) significantly correlated with hospital mortality.
Conclusions: Antibiotic therapy in a SICU can be assessed and analyzed in detail using a PDMS. Furthermore, in this study, the duration of antibiotic therapy and the number of antibiotic agents used correlated with hospital mortality. In further developing PDMSs, it is important for quality-assurance purposes to document the reasons for giving antibiotics and for changing prescriptions. It would also be helpful to integrate certain therapy standards and reminder functions for the duration of therapy in the PDMS.</abstract><cop>United States</cop><pub>EM Inc USA</pub><pmid>15262462</pmid><doi>10.1016/S0149-2918(04)90135-X</doi><tpages>10</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0149-2918 |
| ispartof | Clinical therapeutics, 2004-06, Vol.26 (6), p.915-924 |
| issn | 0149-2918 1879-114X |
| language | eng |
| recordid | cdi_proquest_miscellaneous_66720494 |
| source | MEDLINE; Access via ScienceDirect (Elsevier); ProQuest Central UK/Ireland |
| subjects | Adult Anti-Bacterial Agents - classification Anti-Bacterial Agents - therapeutic use antibiotics Bacterial Infections - drug therapy Bacterial Infections - mortality Bacterial Infections - prevention & control computerized patient record critical care drug therapy Drug Utilization Review - statistics & numerical data Female Germany - epidemiology Hospital Information Systems Hospital Mortality Hospitals, University - standards Humans intensive care Intensive Care Units - standards Length of Stay - statistics & numerical data Logistic Models Male Medical Records Systems, Computerized Odds Ratio Outcome and Process Assessment (Health Care) - statistics & numerical data ROC Curve Surgical Procedures, Operative - mortality Surgical Procedures, Operative - standards Surgical Wound Infection - drug therapy Surgical Wound Infection - mortality Surgical Wound Infection - prevention & control Treatment Outcome |
| title | Review of antibiotic drug use in a surgical ICU: Management with a patient data management system for additional outcome analysis in patients staying more than 24 hours |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-23T21%3A07%3A21IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Review%20of%20antibiotic%20drug%20use%20in%20a%20surgical%20ICU:%20Management%20with%20a%20patient%20data%20management%20system%20for%20additional%20outcome%20analysis%20in%20patients%20staying%20more%20than%2024%20hours&rft.jtitle=Clinical%20therapeutics&rft.au=Hartmann,%20Bernd&rft.date=2004-06-01&rft.volume=26&rft.issue=6&rft.spage=915&rft.epage=924&rft.pages=915-924&rft.issn=0149-2918&rft.eissn=1879-114X&rft_id=info:doi/10.1016/S0149-2918(04)90135-X&rft_dat=%3Cproquest_cross%3E66720494%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1032919246&rft_id=info:pmid/15262462&rft_els_id=S014929180490135X&rfr_iscdi=true |