Programa Stewardship de antimicrobianos em Unidade de Terapia Intensiva adulto: Uma revisão integrativa

Luana Cristina Maia de  Oliveira; Lizzianne Kretli Winkelstroter  Eller; Adriano Messias de  Souza

doi:10.33448/rsd-v13i6.45883

Autores

Luana Cristina Maia de Oliveira Universidade do Oeste Paulista https://orcid.org/0009-0008-1514-3457
Lizzianne Kretli Winkelstroter Eller Universidade do Oeste Paulista https://orcid.org/0000-0001-9352-2630
Adriano Messias de Souza Hospital Regional de Presidente Prudente https://orcid.org/0000-0001-9462-6503

DOI:

https://doi.org/10.33448/rsd-v13i6.45883

Palavras-chave:

Unidade de terapia intensiva; Resistência bacteriana; Controle de infecção; Stewardship de antimicrobianos.

Resumo

Pacientes internados em UTI estão mais propensos a adquirir infecções relacionadas à saúde devido ao seu quadro clínico grave e o uso inadequado dos antimicrobianos que pode acarretar no aumento de resistência bacteriana. Neste contexto, uma estratégia para o controle da resistência bacteriana é o Antimicrobial Stewardship definido como intervenções coordenadas para diminuir o uso inadequado dos antimicrobianos, reduzir o desenvolvimento de resistência e reduzir custos. Objetivo: Realizar uma revisão integrativa sobre a aplicação do Stewardship de antimicrobianos em desfechos clínicos e econômicos de pacientes adultos internados em UTI. Metodologia: Esta revisão adotou a estratégia PICo para elaboração da pergunta “Quais melhorias que o programa Stewardship de antimicrobianos podem trazer para unidades de terapia intensiva adulto?”. Foram utilizadas as bases de dados: LILACS, PubMed Central, SCOPUS, EMBASE, WEB OF SCIENCE, SCIENCE DIRECT e MEDLINE, com artigos publicados em inglês entre os anos de 2018 a 2023. Os descritores DeCS e MeSH foram: “Intensive Care Units”, “Antimicrobial Stewardship”, “Drug Resistance, Bacterial”, “Infection Control”. Resultados: Doze estudos estavam em concordância com os critérios de inclusão estabelecidos e demonstraram que a adesão às intervenções propostas pelo Programa Stewardship de Antimicrobianos estão associadas a uma diminuição do tempo e doses de terapia antibiótica, além de estimular o uso racional em UTI. Conclusão: O Programa Stewardship de Antimicrobianos em UTI adulto traz benefícios na diminuição na resistência bacteriana e no uso de antimicrobianos. Consequentemente reduzindo custos hospitalares, sendo o farmacêutico a peça chave na estratégia no uso racional e seguro dos antimicrobianos.

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