• Nayá Saad Custódio, Luana Fernandes Machado, Graziela Denardin Luckemeyer, Juliana Devós Syrio, Isabela Shumaher Frutuoso, Debora Augusto Valverde Chanes, Luciana Tirelli Kaltenbacher, Melissa Maia Braz, Mara Correa Lelles Nogueira, Joelma Villafanha Gandolfi, and Suzana Margareth Lobo.
• Faculty of Medicine of São José do Rio Preto - São José do Rio Preto (SP), Brazil.
• Rev Assoc Med Bras (1992). 2024 Jan 1; 70 (5): e20231282e20231282.

ObjectiveThe objective of this study was to evaluate the impact of the implementation of a bundle of interventions through a "Program for Antibiotic Management and Nosocomial Infection Prevention" in the intensive care unit on antibiotic and devices use and healthcare-associated infections.MethodsThis was a quasi-experimental study of consecutive series of cases in periods before and after the establishment of protocols and checklists for the use of antibiotics as well as other measures to prevent healthcare-associated infection as part of a quality improvement program. Antimicrobial consumption was assessed by the defined daily dose.ResultsA total of 1,056 and 1,323 admissions in the pre-intervention and post-intervention phases, respectively, were evaluated. The defined daily dose per 100 patient-day decreased from 89±8 to 77±11 (p=0.100), with a decrease in carbapenems, glycopeptides, polymyxins, penicillins, and cephalosporins. The rates of ventilator and central venous catheter use decreased from 52.8 to 44.1% and from 76 to 70%, respectively. The rates of healthcare-associated infection decreased from 19.2 to 15.5%.ConclusionQuality improvement actions focused primarily on antimicrobial management and prevention of healthcare-associated infection are feasible and have the potential to decrease antibiotic use and healthcare-associated infection rates.

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