• Medicina intensiva · Jan 2017

    Comparative Study Observational Study

    Impact of the implementation of a Sepsis Code hospital protocol in antibiotic prescription and clinical outcomes in an intensive care unit.

    • L García-López, S Grau-Cerrato, A de Frutos-Soto, F Bobillo-De Lamo, R Cítores-Gónzalez, F Diez-Gutierrez, M F Muñoz-Moreno, T Sánchez-Sánchez, F Gandía-Martínez, D Andaluz-Ojeda, and Grupo de Trabajo Multidisciplinar en Código Sepsis del Hospital Clínico Universitario de Valladolid.
    • Servicio de Farmacia, Hospital Clínico Universitario de Valladolid, Valladolid, España.
    • Med Intensiva. 2017 Jan 1; 41 (1): 12-20.

    IntroductionA study was performed to analyze the impact of an in-hospital Sepsis Code (SC) program on use of antibiotic and clinical outcomes.DesignQuasi-experimental observational retrospective study.SettingPolyvalent 11 beds ICU belonging to a tertiary Universitary hospital.PatientsPatients admitted consecutively to the ICU with diagnosis of severe sepsis or septic shock.InterventionsA post intervention group (POST-SC) (September 2012-August 2013) was compared with a historical group (PRE-SC) used as control (January-December 2010).VariablesAntibiotic treatment, therapeutic antibiotic strategy, mortality and length of stay. Antibiotic consumption was expressed as defined daily doses (DDD)/ 100 stays.Results42 patients with SS/SS in POST-SC group and 50 patients in PRE-SC group were consecutively recluted and further analyzed. Total antibiotic consumption (DDD) was similar in both groups. Rate of de-escalation therapy was significantly higher in POST-SC group (75% vs 30,8%, p<0,005) while prescription of restricted antibiotics was significantly lower (74% vs 52%, p=0,031). Finally POST-SC patients showed a significantly decrease in hospital and 28 days mortality rates [23% vs 44%, (p=0,035) and 31% vs 56% (p=0,014) respectively] as well as a reduction in ICU length of stay compared to PRE-SC cohort (5 days vs 10,5 days, p=0,05).ConclusionThe implementation of a Sepsis Code-hospital protocol is associated to an improvement in the management of antibiotic therapy with a significant increase in de-escalation therapy and lesser utilization of restricted use antibiotics, as well as a significant reduction in mortality, and a tendency towards shorter ICU length stay.Copyright © 2016 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

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