RESUMEN
BACKGROUND: Antimicrobial stewardship programmes (ASPs) include strategies that enable sustainable management of rational anti-infective treatment in the clinical setting. The successful introduction of ASPs requires close interdisciplinary collaboration among various health professionals, including the hospital management. So far, ASPs have been evaluated mainly from a clinical-pharmacological and infectious disease perspective. AIM: To identify and evaluate parameters with decisive significance for the economic impact of ASPs. METHODS: A systematic literature search for peer-reviewed health-economic studies associated with antimicrobial stewardship programmes was performed. Primary outcomes included savings in drug costs and lower revenue losses for hospitals. FINDINGS AND CONCLUSIONS: A total of 16 studies met all inclusion criteria. Most of the evidence from published clinical trials demonstrated savings through reduced direct cost of antibiotics. However, there are also studies that prove revenue effects of ASPs through decreases in length of stay and readmission rates.
Asunto(s)
Antibacterianos/economía , Programas de Optimización del Uso de los Antimicrobianos/economía , Utilización de Medicamentos/economía , Costos de la Atención en Salud/estadística & datos numéricos , Hospitales , Antibacterianos/uso terapéutico , HumanosRESUMEN
AIM: To compare the tissue tolerance and efficacy of two wound antiseptics with tissue-tolerable plasma (TTP) on enucleated contaminated eyes from slaughtered pigs in order to draw consequences for the use of TTP on wounds. METHOD: The corneas of extracted eyes were contaminated with Staphylococcus aureus or Pseudomonas aeruginosa. One and 10 min after application of 10% povidone (PVP)-iodine and 0.04% polyhexanide, respectively, the eyes were rinsed with inactivating solution. To test TTP, the plasma pen meandered over the eyes at a speed of 30 mm/s and a distance of 5 mm; the eyes were then rinsed with balanced salt solution. The reduction factor was calculated by the difference between the logarithm of colony-forming units in the rinse before and after antisepsis or TTP application. RESULTS: The efficacy of TTP (reduction factor 2.4-2.9) was significantly higher (p < 0.001) than that of PVP-iodine and polyhexanide (reduction factor 1.7-2.1). CONCLUSION: TTP is more effective than the tested wound antiseptics. The lack of histological damage to the eyes of slaughtered pigs would seem to make its use as a wound antiseptic a viable alternative. In contrast to antiseptics, it supplies additional energy in the form of heat, electric fields and radicals by TTP.