J Telemed Telecare - Antimicrobial stewardship through telemedicine in a community hospital in Southern Brazil.

Tópicos

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Resumo

We developed an antimicrobial stewardship programme, based on telemedicine, for a remote community hospital in southern Brazil. Expertise in infectious diseases was provided from a 250-bed tertiary hospital for cardiology patients located 575 km away. At the community hospital, antimicrobial prescriptions were completed via a secure web site. A written reply was sent back to the prescriber by email and SMS text message. During a 4-month study period there were 81 prescriptions for 76 patients. Most antimicrobial prescriptions (67%) were for respiratory infections. Ampicillin was prescribed in 44% of cases (n = 56), gentamicin in 18% of cases (n = 23) and azithromycin in 18% of cases (n = 23). Two infectious diseases specialists independently reviewed each antimicrobial prescription. A total of 41 prescriptions (55%) were considered inappropriate. The median time to obtain a second opinion via the web site was 22 min (interquartile range 12-55). Overall compliance with the recommendations of the infectious diseases specialist was 100% (81 out of 81 requests). Telemedicine appears to have a useful potential role in antimicrobial stewardship programmes.

Resumo Limpo

develop antimicrobi stewardship programm base telemedicin remot communiti hospit southern brazil expertis infecti diseas provid bed tertiari hospit cardiolog patient locat km away communiti hospit antimicrobi prescript complet via secur web site written repli sent back prescrib email sms text messag month studi period prescript patient antimicrobi prescript respiratori infect ampicillin prescrib case n gentamicin case n azithromycin case n two infecti diseas specialist independ review antimicrobi prescript total prescript consid inappropri median time obtain second opinion via web site min interquartil rang overal complianc recommend infecti diseas specialist request telemedicin appear use potenti role antimicrobi stewardship programm

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