Use of double-carbapenem therapy in an intensive care unit
Infections in critically ill patients admitted to Intensive Care Units (ICUs), especially Healthcare-Associated Infections (HAIs), are common due to the severity of clinical condition and invasive procedures, increasing susceptibility to infections mainly caused by multidrug-resistant microorganisms...
| Autores: | , , , , |
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| Tipo de recurso: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2025 |
| País: | Brasil |
| Institución: | Editora JRG |
| Repositorio: | Revista JRG de Estudos Acadêmicos |
| Idioma: | portugués |
| OAI Identifier: | oai:ojs2.revistajrg.com:article/1844 |
| Acceso en línea: | http://revistajrg.com/index.php/jrg/article/view/1844 |
| Access Level: | acceso abierto |
| Palabra clave: | Unidades de Terapia Intensiva Infecções Bacterianas Carbapenêmicos Enterobacteriáceas Resistentes a Carbapenêmicos Farmacorresistência Bacteriana Múltipla Intensive Care Units; Bacterial Infections; Carbapenems; Carbapenem-Resistant Enterobacteriaceae; Multiple Drug Resistance Bacterial. |
| Sumario: | Infections in critically ill patients admitted to Intensive Care Units (ICUs), especially Healthcare-Associated Infections (HAIs), are common due to the severity of clinical condition and invasive procedures, increasing susceptibility to infections mainly caused by multidrug-resistant microorganisms. Observational studies have shown some benefit of using double-carbapenem therapy in treatment of severe infections, especially those caused by multidrug-resistant gram-negative bacteria. A survey was conducted on the profile of double-carbapenem use in the ICU of a public hospital in the Federal District through retrospective data collection from the medical records of 72 critically ill adult patients who had used a double-carbapenem therapeutic regimen for at least 48 hours between March 2021 and February 2023. The average age was 54 years, with respiratory diseases, notably acute respiratory failure from COVID-19, being the main reason for hospitalization. The start of treatment was mostly empirical (81.94%), and the majority of patients (61.11%) had at least one positive culture result during their hospitalization in the ICU, with an average stay of 29.4 days. Among the cultures that led to double-carbapenem use, there was a predominance of the identification of multidrug-resistant Klebsiella pneumoniae bacteria. Almost all patients received an increased dose of meropenem in extended infusion, associated with ertapenem with optimized scheduling. There were 37 (51.39%) deaths, and it was not possible to establish a relationship with the treatment. By identifying the use profile of the double-carbapenem regimen, it is possible to observe the need for a multidisciplinary and integrated approach to promote its judicious use through assertive actions, such as continuous education and the adoption of institutional protocols to optimize infection treatment in the ICU. |
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