Monitoramento clínico de terapia antimicrobiana: uma análise do perfil de resistência em um hospital universitário

This study aimed to monitor the consumption of antimicrobials in a University Hospital, evaluating the profile of resistance to the strains tested, in the period from 2015 to 2017. This is a longitudinal, analytical study, with retrospective data collection carried out at the University Hospital from the Federal University of Piaui, with approximately 190 inpatient beds, in the period from 2015 to 2017. The variables studied were: DDD (Defined Daily Dose) and DOT (Days of therapy) indicators and microorganism resistance profile. Secondary data were collected after a positive opinion from the Ethics Committee. The first stage of the study verified the standardized antimicrobials from the hospital's drug list. Then, standardized antimicrobial consumption control data by the Hospital Infection Control Commission were used, with information on the antimicrobial used, dose, route of administration, dosage, hospitalization place, days of treatment of antimicrobials and data from management reports of the Application Management for University Hospitals. The results showed a reduction for the defined daily dose indicators in the first year, but soon after an increase in consumption between the years, listing the restricted use antimicrobials (liposomal amphotericin B, anidulafungin, linezolid, polymyxin B and tigecycline) and the group of carbapenems (imipenem and meorpenem). The DOT, on the other hand, showed a statistically significant decrease during the study period. Considering the resistance profile of microorganisms to antimicrobials, there was a growing increase in resistant strains in the period from 2016 to 2017. It is concluded that with the analysis methods for measuring consumption, they are tools that guide the management of the rational use of antimicrobials within the institution, contributing to control the resistance profile of the main strains.