Assessing the frequency of dose adjustment in acute renal dysfunction and the excess costs of antibiotic therapy in a teaching hospital
DOI:
https://doi.org/10.17058/rips.v8i1.18272Keywords:
Antimicrobial Stewardship, Dosage, Acute Kidney Injury, PharmaceuticalAbstract
Objectives: to evaluate the frequency of dose adjustment of antimicrobials in the face of acute kidney injury, the estimated excess costs with the use of these medications and the use of dialysis during the hospital stay. Methodology: cross-sectional observational study, carried out with 30 patients from a teaching hospital, who used oral and parenteral antimicrobials, concomitantly with the episode of acute kidney injury, and with dose adjustment predicted for such dysfunction. Data regarding the prescribed antimicrobials and the costs involved were collected from the hospital's computerized system. For statistical analysis, mean, standard deviation and absolute frequency were used. Results: the patients had a mean age of 70.6 ±14 years, 13 males and 17 females. Of these, three patients underwent hemodialysis sessions during the hospital stay. Among the prescribed antimicrobials, 33 were in disagreement with the literature used to analyze the prescriptions. Among the treatments performed, nine exceed the treatment time recommended by the medical team, ranging from one to three more days of use, depending on the prescribed antimicrobial, generating an estimated excess cost of R$ 538.57 with antibiotic therapy. Conclusion: the aspects observed in this study reinforce the importance of monitoring the prescriptions and consumption of antimicrobials, especially among the elderly population, avoiding the use of inappropriate doses, in view of physiological changes that may be present, as well as the length of treatment recommended, with a view to reducing the costs involved and optimizing available resources.
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