Ir J Med Sci (2017) 186:729–732 DOI 10.1007/s11845-016-1504-9 ORIGINAL ARTICLE Targeted de-escalation rounds may effectively and safely reduce meropenem use 1 2 3 4 3 • • • • • U. Ni Riain M. Tierney C. Doyle A. Vellinga C. Fleming M. Cormican Received: 10 June 2016 / Accepted: 17 September 2016 / Published online: 29 September 2016 Royal Academy of Medicine in Ireland 2016 Abstract The median days of meropenem use in patients where Objective Use of meropenem in our hospital has doubled meropenem was de-escalated was 4.5 days (range 2–19) in recent years. An audit in 2013 showed that although compared with 14 days (range 6–84) where de-escalation initiation of therapy with meropenem was generally was not recommended or the recommendation was not appropriate, therapy was rarely subsequently reviewed and implemented. There was no statistically signiﬁcant differ- de-escalated where appropriate. Therefore, a structured ence in crude mortality between patients de-escalated from stewardship initiative focussed on meropenem de-escala- meropenem and those where meropenem was continued. tion was developed. Conclusion This pilot study suggests that targeted car- Methods A local guideline for review and de-escalation of bapenem de-escalation stewardship activity based on pre- meropenem was developed and approved by
Irish Journal of Medical Science (1971 -) – Springer Journals
Published: Sep 29, 2016
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