Resumen de Impacto de un programa de terapia secuencial antimicrobiana (TSA) con fluoroquinolonas en una unidad de geriatría
Javier José del Pozo Ruiz, Encarnación Martín Pérez
Objectives: To assess the impact of the pharmaceutical intervention (PI) on the implementation of sequential therapy (ST) with fluoroquinolones (ciprofloxacin and levofloxacin) on the third day of treatment. Method: Prospective and comparative study of pharmaceutical intervention in two five-month stages. It was agreed that on the third day of treatment with intravenous fluoroquinolone, prior to its administration, a newsletter would be prepared, along with a notice on the program of electronic prescription about the ST and its benefits. In order to determine the effectiveness and functioning of such program, we compared between both patient groups the following variables: day of conversion of antibiotic to oral route, days of antibiotic by intravenous and oral routes, days of hospital stay, cost of treatment based on the laboratory selling price (LSP), consumption in Daily Defined Dose per 100 stays (DDD/100S), diagnosis, and re-admissions due to re-infection during a month. Results: We studied a total of 111 patients that took intravenous fluoroquinolones and were susceptible of sequential antimicrobial therapy, and divided them in two groups: the group without pharmaceutical intervention for SAT, which served as the control group, with 52 patients (25 with ciprofloxacin and 27 with levofloxacin) and another group of 59 patients (30 with levofloxacin and 29 with ciprofloxacin) who received a pharmaceutical intervention for promoting the SAT. The pharmaceutical intervention clearly showed a decrease in the day of conversion to oral route, lower number of days with intravenous fluoroquinolone, higher number of days by oral route, a cost reduction on LSP, and a reduction in DDD/100S consumption. We did not observe any significant differences between both groups regarding hospital stay and antibiotic treatment. Conclusions: The implementation of a ST program is one of the best and most interesting opportunities to integrate the hospital pharmacist's role within the healthcare team, and in this way achieving a cost-effective treatment alternative. Hospital stay was not reduced in a significant way due to the patients' characteristics (fragile elderly patients with extensive multiple pathology)
