HUBU managed to close 2022 with a decrease in the consumption of antibiotics, after two years of ups and downs in most of the indicators used to analyze the evolution of the consumption of this type of medication in patients; ups and downs of different intensity that can hardly be separated from the SARS-CoV-2 coronavirus pandemic.
Part of the recovery from the downward trend in the prescription of antimicrobials in the complex is attributed, in fact, to the fact that the Microbiology service decided to introduce night shifts in its staff in March 2020. The objective was to advance positive diagnoses in SARS-CoV-2, which is a virus and is not treated with antibiotics, has also accelerated outcomes in infections of bacterial origin. And this has allowed treatments to be more adjusted, both in dose and spectrum. Something that, in addition to benefiting the patient and reducing unnecessary costs, also affects a priority issue around the world: helping to reduce the risk of the emergence of resistance to antibiotics.
The fact that common bacteria are getting stronger against antibiotics means that the day may come when the infections that are now cleared by these drugs again become life threatening. “A growing number of illnesses such as pneumonia, tuberculosis, sepsis, gonorrhea or food-borne illnesses are increasingly difficult to treat; sometimes impossible”, says the specialist doctor and coordinator of the Antimicrobial Use Optimization Program (PROA) at the hospital, Carolina Navarro, via email. Hence the urgency of a change in the use of these drugs.
The drop registered last year at HUBU in the consumption of antibacterials is not spectacular (from the 2.36 daily doses defined per 1,000 inhabitants in 2020 to 2.07 in 2022), but it is again close to the balance of 2019, when it was possible to close below two daily doses (1.98, always for every 1,000 inhabitants in the reference area of the assistance complex in the capital and according to official data from the Ministry of Health).
But it is important that the downward trend has returned, as pointed out by Navarro, who specializes in infectious diseases in internal medicine. «HUBU remains on the average for Sacyl hospitals in its category, but when an anomaly is detected in the consumption of a given medicine, we assess which type of patients receive it – which service they depend on, what type of pathology they have… ..- the causes are analyzed and the corresponding measures are proposed and implemented to correct it”, he explains.
In the region. In the use of antibacterials in general, HUBU has improved and, among the big five in the Community, it is the third with the lowest consumption. Ahead are those from León and Salamanca and, behind, the two from Valladolid, where there has been a significant worsening of data during the pandemic.
And with regard to medicines to try to treat diseases caused by fungi, antifungals, the Burgos hospital is once again the second in the Community with the lowest consumption (always in relation to the other four hospitals in its category), a position it occupied before the pandemic Only León is at the bottom, according to Sacyl.
The HUBU was a pioneer in Castilla y León in the implementation of PROA – this year marks a decade since its launch – and Navarro points out that, in general, it was possible “to standardize the care of bacteremia early and, in recent years, even faster because we have a microbiologist on call”. This, highlights the specialist in Internal Medicine, “provides microbiological information almost immediately”. That is, if the infection is of viral or bacterial origin, or even if it is a pathology caused by fungi. And, in the case of bacteria, what kind. This makes it possible to administer the most appropriate antibiotic and for the necessary time; neither more nor less. “The consumption of antimicrobials has been monitored and improved, with all that that implies, both for the impact on antimicrobial resistance and for the direct economic impact on the economy that this entails.”
In fact, during the first years of PROA at the HUBU, a study was carried out which concluded that optimizing the management of these drugs led to savings of 58,000 euros just during the four months of investigation.