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Characterization of antibiotic prescription in intensive care units according to the Access, Watch, and Reserve classification.

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Title: Characterization of antibiotic prescription in intensive care units according to the Access, Watch, and Reserve classification.
Alternate Title: Caracterización de la prescripción de antibióticos en unidades de cuidados intensivos según la clasificación Access, Watch y Reserve.
Caracterização da prescrição de antibióticos em unidades de terapia intensiva segundo a classificação Access, Watch and Reserve.
Authors: Solórzano, Carlos Augusto1 carlossolorzano@fcv.org, Manrique-Hernández, Edgar Fabián1,2 fabianmh1993@gmail.com, Miranda Barajas, Angela1 angelammirandab@gmail.com, Caro, María Alejandra1 mariacaro@fcv.org, Rubio, María Camila1 marcamilarubio240@gmail.com, Licht-Ardila, Maricel1 mlichtart@gmail.com, Hurtado-Ortiz, Alexandra1,3 alexandrahurtado@fcv.org
Source: Revista Cuidarte. May-Aug2025, Vol. 16 Issue 2, p1-13. 13p.
Subjects: ANTIBIOTICS, CROSS-sectional method, COMMUNICABLE diseases, MEDICAL prescriptions, CRITICALLY ill, PATIENTS, T-test (Statistics), CARDIOVASCULAR diseases, MULTIPLE regression analysis, ANTIMICROBIAL stewardship, DRUG resistance in microorganisms, HEALTH insurance, HYPERTENSION, MULTIVARIATE analysis, AMPICILLIN, CHI-squared test, MANN Whitney U Test, DESCRIPTIVE statistics, HOSPITAL mortality, CHRONIC kidney failure, INTENSIVE care units, RESEARCH, STATISTICS, ANTIBIOTIC prophylaxis, DATA analysis software, TUMORS, CEREBROVASCULAR disease, DRUG utilization, COMORBIDITY, DIABETES, ADULTS
Abstract (English): Introduction: The inappropriate use of antibiotics in intensive care units poses risks, such as increased infections caused by multidrug-resistant bacteria and adverse reactions. The World Health Organization's strategy, named Access, Watch, and Reserve, aims to mitigate these risks by categorizing antibiotics into these categories. Objective: To characterize antibiotic consumption in the adult population of intensive care units during the first quarter of 2023. Materials and Methods: A cross-sectional study on patients in intensive care units was conducted. A bivariate and multivariate analyses with logistic regression were carried out. Results: 807 intensive care unit patients were studied, with a median age of 60 years. Piperacillin/tazobactam was the most prescribed antibiotic. According to the Access, Watch, and Reserve classification, 77.96% of prescriptions fell into Watch category, 11.29% into Reserve, and 10.75% into Access. Discussion: Antibiotic use in intensive care units is crucial for managing critically ill patients. Our study focuses on the challenges of antibiotic selection, complication management, and emphasizes antimicrobial stewardship for optimal therapy and reduced resistance. Conclusion: It is crucial to conduct an intervention study to demonstrate how increasing interaction of the antimicrobial stewardship team during prescription can enhance antibiotic use, reduce side effects, and decrease unnecessary costs. [ABSTRACT FROM AUTHOR]
Abstract (Spanish): Introducción: El uso inapropiado de antibióticos en unidades de cuidados intensivos conlleva riesgos como el aumento de infecciones causadas por bacterias multiresistentes y reacciones adversas. La estrategia de la Organización Mundial de la Salud, denominada Acceso, Vigilancia y Reserva, tiene como objetivo mitigar estos riesgos al clasificar los antibióticos en estas categorías. Objetivo: Caracterizar el consumo de antibióticos en la población adulta de las unidades de cuidados intensivos durante el primer trimestre de 2023. Materiales y Métodos: Se realizó un estudio transversal de pacientes en unidades de cuidados intensivos. Se llevó a cabo un análisis bivariado y multivariado con regresión logística. Resultados: Se estudiaron 807 pacientes en unidades de cuidados intensivos, con una edad media de 60 años. El antibiótico más prescrito fue Piperacilina/Tazobactam. En la clasificación de Acceso, Vigilancia y Reserva, el 77.96% de las prescripciones fueron Vigilancia, el 11.29% Reserva y el 10.75% Acceso. Discusión: El uso de antibióticos en las unidades de cuidados intensivos es crucial para el manejo de pacientes críticamente enfermos. Nuestro estudio se centra en los desafíos de la selección de antibióticos, el manejo de complicaciones y enfatiza la administración para una terapia óptima y una reducción de la resistencia. Conclusión: Es crucial realizar un estudio de intervención que demuestre cómo aumentar la interacción entre el equipo de administración de antimicrobianos durante la prescripción puede mejorar su uso, reducir los efectos secundarios y disminuir los costos innecesarios. [ABSTRACT FROM AUTHOR]
Abstract (Portuguese): Introdução: O uso inadequado de antibióticos em unidades de terapia intensiva traz riscos como aumento de infecções causadas por bactérias multirresistentes e reações adversas. A estratégia da Organização Mundial da Saúde, denominada Acesso, Vigilância e Reserva, visa mitigar esses riscos categorizando os antibióticos nessas categorias. Objetivo: Caracterizar o consumo de antibióticos na população adulta de unidades de terapia intensiva durante o primeiro trimestre de 2023. Materiais e Métodos: Foi realizado um estudo transversal em pacientes em unidades de terapia intensiva. Foi realizada uma análise bivariada e multivariada com regressão logística. Resultados: Foram estudados 807 pacientes de unidade de terapia intensiva, com mediana de idade de 60 anos. O antibiótico mais prescrito foi Piperacilina/Tazobactam. Na classificação de Acesso, Vigilância e Reserva, 77,96% das prescrições foram Vigilância, 11,29% Reserva e 10,75% Acesso. Discussão: O uso de antibióticos em unidades de terapia intensiva é crucial para o tratamento de pacientes gravemente doentes. Nosso estudo se concentra nos desafios da seleção de antibióticos, no tratamento de complicações e enfatiza a administração para terapia ideal e resistência reduzida. Conclusão: É crucial conduzir um estudo de intervenção demonstrando como o aumento da interação entre a equipe de administração antimicrobiana durante a prescrição pode aumentar seu uso, reduzir efeitos colaterais e diminuir custos desnecessários. [ABSTRACT FROM AUTHOR]
Copyright of Revista Cuidarte is the property of Universidad de Santander and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Characterization of antibiotic prescription in intensive care units according to the Access, Watch, and Reserve classification.
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  Data: Caracterización de la prescripción de antibióticos en unidades de cuidados intensivos según la clasificación Access, Watch y Reserve.<br />Caracterização da prescrição de antibióticos em unidades de terapia intensiva segundo a classificação Access, Watch and Reserve.
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  Data: <searchLink fieldCode="AR" term="%22Solórzano%2C+Carlos+Augusto%22">Solórzano, Carlos Augusto</searchLink><relatesTo>1</relatesTo><i> carlossolorzano@fcv.org</i><br /><searchLink fieldCode="AR" term="%22Manrique-Hernández%2C+Edgar+Fabián%22">Manrique-Hernández, Edgar Fabián</searchLink><relatesTo>1,2</relatesTo><i> fabianmh1993@gmail.com</i><br /><searchLink fieldCode="AR" term="%22Miranda+Barajas%2C+Angela%22">Miranda Barajas, Angela</searchLink><relatesTo>1</relatesTo><i> angelammirandab@gmail.com</i><br /><searchLink fieldCode="AR" term="%22Caro%2C+María+Alejandra%22">Caro, María Alejandra</searchLink><relatesTo>1</relatesTo><i> mariacaro@fcv.org</i><br /><searchLink fieldCode="AR" term="%22Rubio%2C+María+Camila%22">Rubio, María Camila</searchLink><relatesTo>1</relatesTo><i> marcamilarubio240@gmail.com</i><br /><searchLink fieldCode="AR" term="%22Licht-Ardila%2C+Maricel%22">Licht-Ardila, Maricel</searchLink><relatesTo>1</relatesTo><i> mlichtart@gmail.com</i><br /><searchLink fieldCode="AR" term="%22Hurtado-Ortiz%2C+Alexandra%22">Hurtado-Ortiz, Alexandra</searchLink><relatesTo>1,3</relatesTo><i> alexandrahurtado@fcv.org</i>
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  Data: <searchLink fieldCode="JN" term="%22Revista+Cuidarte%22">Revista Cuidarte</searchLink>. May-Aug2025, Vol. 16 Issue 2, p1-13. 13p.
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  Data: <searchLink fieldCode="DE" term="%22ANTIBIOTICS%22">ANTIBIOTICS</searchLink><br /><searchLink fieldCode="DE" term="%22CROSS-sectional+method%22">CROSS-sectional method</searchLink><br /><searchLink fieldCode="DE" term="%22COMMUNICABLE+diseases%22">COMMUNICABLE diseases</searchLink><br /><searchLink fieldCode="DE" term="%22MEDICAL+prescriptions%22">MEDICAL prescriptions</searchLink><br /><searchLink fieldCode="DE" term="%22CRITICALLY+ill%22">CRITICALLY ill</searchLink><br /><searchLink fieldCode="DE" term="%22PATIENTS%22">PATIENTS</searchLink><br /><searchLink fieldCode="DE" term="%22T-test+%28Statistics%29%22">T-test (Statistics)</searchLink><br /><searchLink fieldCode="DE" term="%22CARDIOVASCULAR+diseases%22">CARDIOVASCULAR diseases</searchLink><br /><searchLink fieldCode="DE" term="%22MULTIPLE+regression+analysis%22">MULTIPLE regression analysis</searchLink><br /><searchLink fieldCode="DE" term="%22ANTIMICROBIAL+stewardship%22">ANTIMICROBIAL stewardship</searchLink><br /><searchLink fieldCode="DE" term="%22DRUG+resistance+in+microorganisms%22">DRUG resistance in microorganisms</searchLink><br /><searchLink fieldCode="DE" term="%22HEALTH+insurance%22">HEALTH insurance</searchLink><br /><searchLink fieldCode="DE" term="%22HYPERTENSION%22">HYPERTENSION</searchLink><br /><searchLink fieldCode="DE" term="%22MULTIVARIATE+analysis%22">MULTIVARIATE analysis</searchLink><br /><searchLink fieldCode="DE" term="%22AMPICILLIN%22">AMPICILLIN</searchLink><br /><searchLink fieldCode="DE" term="%22CHI-squared+test%22">CHI-squared test</searchLink><br /><searchLink fieldCode="DE" term="%22MANN+Whitney+U+Test%22">MANN Whitney U Test</searchLink><br /><searchLink fieldCode="DE" term="%22DESCRIPTIVE+statistics%22">DESCRIPTIVE statistics</searchLink><br /><searchLink fieldCode="DE" term="%22HOSPITAL+mortality%22">HOSPITAL mortality</searchLink><br /><searchLink fieldCode="DE" term="%22CHRONIC+kidney+failure%22">CHRONIC kidney failure</searchLink><br /><searchLink fieldCode="DE" term="%22INTENSIVE+care+units%22">INTENSIVE care units</searchLink><br /><searchLink fieldCode="DE" term="%22RESEARCH%22">RESEARCH</searchLink><br /><searchLink fieldCode="DE" term="%22STATISTICS%22">STATISTICS</searchLink><br /><searchLink fieldCode="DE" term="%22ANTIBIOTIC+prophylaxis%22">ANTIBIOTIC prophylaxis</searchLink><br /><searchLink fieldCode="DE" term="%22DATA+analysis+software%22">DATA analysis software</searchLink><br /><searchLink fieldCode="DE" term="%22TUMORS%22">TUMORS</searchLink><br /><searchLink fieldCode="DE" term="%22CEREBROVASCULAR+disease%22">CEREBROVASCULAR disease</searchLink><br /><searchLink fieldCode="DE" term="%22DRUG+utilization%22">DRUG utilization</searchLink><br /><searchLink fieldCode="DE" term="%22COMORBIDITY%22">COMORBIDITY</searchLink><br /><searchLink fieldCode="DE" term="%22DIABETES%22">DIABETES</searchLink><br /><searchLink fieldCode="DE" term="%22ADULTS%22">ADULTS</searchLink>
– Name: Abstract
  Label: Abstract (English)
  Group: Ab
  Data: Introduction: The inappropriate use of antibiotics in intensive care units poses risks, such as increased infections caused by multidrug-resistant bacteria and adverse reactions. The World Health Organization's strategy, named Access, Watch, and Reserve, aims to mitigate these risks by categorizing antibiotics into these categories. Objective: To characterize antibiotic consumption in the adult population of intensive care units during the first quarter of 2023. Materials and Methods: A cross-sectional study on patients in intensive care units was conducted. A bivariate and multivariate analyses with logistic regression were carried out. Results: 807 intensive care unit patients were studied, with a median age of 60 years. Piperacillin/tazobactam was the most prescribed antibiotic. According to the Access, Watch, and Reserve classification, 77.96% of prescriptions fell into Watch category, 11.29% into Reserve, and 10.75% into Access. Discussion: Antibiotic use in intensive care units is crucial for managing critically ill patients. Our study focuses on the challenges of antibiotic selection, complication management, and emphasizes antimicrobial stewardship for optimal therapy and reduced resistance. Conclusion: It is crucial to conduct an intervention study to demonstrate how increasing interaction of the antimicrobial stewardship team during prescription can enhance antibiotic use, reduce side effects, and decrease unnecessary costs. [ABSTRACT FROM AUTHOR]
– Name: Abstract
  Label: Abstract (Spanish)
  Group: Ab
  Data: Introducción: El uso inapropiado de antibióticos en unidades de cuidados intensivos conlleva riesgos como el aumento de infecciones causadas por bacterias multiresistentes y reacciones adversas. La estrategia de la Organización Mundial de la Salud, denominada Acceso, Vigilancia y Reserva, tiene como objetivo mitigar estos riesgos al clasificar los antibióticos en estas categorías. Objetivo: Caracterizar el consumo de antibióticos en la población adulta de las unidades de cuidados intensivos durante el primer trimestre de 2023. Materiales y Métodos: Se realizó un estudio transversal de pacientes en unidades de cuidados intensivos. Se llevó a cabo un análisis bivariado y multivariado con regresión logística. Resultados: Se estudiaron 807 pacientes en unidades de cuidados intensivos, con una edad media de 60 años. El antibiótico más prescrito fue Piperacilina/Tazobactam. En la clasificación de Acceso, Vigilancia y Reserva, el 77.96% de las prescripciones fueron Vigilancia, el 11.29% Reserva y el 10.75% Acceso. Discusión: El uso de antibióticos en las unidades de cuidados intensivos es crucial para el manejo de pacientes críticamente enfermos. Nuestro estudio se centra en los desafíos de la selección de antibióticos, el manejo de complicaciones y enfatiza la administración para una terapia óptima y una reducción de la resistencia. Conclusión: Es crucial realizar un estudio de intervención que demuestre cómo aumentar la interacción entre el equipo de administración de antimicrobianos durante la prescripción puede mejorar su uso, reducir los efectos secundarios y disminuir los costos innecesarios. [ABSTRACT FROM AUTHOR]
– Name: Abstract
  Label: Abstract (Portuguese)
  Group: Ab
  Data: Introdução: O uso inadequado de antibióticos em unidades de terapia intensiva traz riscos como aumento de infecções causadas por bactérias multirresistentes e reações adversas. A estratégia da Organização Mundial da Saúde, denominada Acesso, Vigilância e Reserva, visa mitigar esses riscos categorizando os antibióticos nessas categorias. Objetivo: Caracterizar o consumo de antibióticos na população adulta de unidades de terapia intensiva durante o primeiro trimestre de 2023. Materiais e Métodos: Foi realizado um estudo transversal em pacientes em unidades de terapia intensiva. Foi realizada uma análise bivariada e multivariada com regressão logística. Resultados: Foram estudados 807 pacientes de unidade de terapia intensiva, com mediana de idade de 60 anos. O antibiótico mais prescrito foi Piperacilina/Tazobactam. Na classificação de Acesso, Vigilância e Reserva, 77,96% das prescrições foram Vigilância, 11,29% Reserva e 10,75% Acesso. Discussão: O uso de antibióticos em unidades de terapia intensiva é crucial para o tratamento de pacientes gravemente doentes. Nosso estudo se concentra nos desafios da seleção de antibióticos, no tratamento de complicações e enfatiza a administração para terapia ideal e resistência reduzida. Conclusão: É crucial conduzir um estudo de intervenção demonstrando como o aumento da interação entre a equipe de administração antimicrobiana durante a prescrição pode aumentar seu uso, reduzir efeitos colaterais e diminuir custos desnecessários. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of Revista Cuidarte is the property of Universidad de Santander and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=lth&AN=190364199
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        Value: 10.15649/cuidarte.4340
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        Text: English
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      – SubjectFull: ANTIBIOTICS
        Type: general
      – SubjectFull: CROSS-sectional method
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      – SubjectFull: INTENSIVE care units
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      – TitleFull: Characterization of antibiotic prescription in intensive care units according to the Access, Watch, and Reserve classification.
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              Text: May-Aug2025
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