Локальний формуляр призначення антибактеріальної терапії в хірургічних підрозділах Клінічної лікарні «Феофанія»

During clinical and analytical work, we have analyzed the microbial landscape of cultures isolated from clinical material of surgical units of the Clinical hospital «Feofaniia» in 2013–2014. The special attention was paid to studying the spread of the extended spectrum beta lactamase among Enterobacteriaceae, which caused nosocomial infection. Based on the findings, as well as on the results of the implementation in our practical work of the international principles of Antimicrobial Stewardship, in the Clinical hospital «Feofaniia» there has been created a local formulary for the administration of antibacterial drugs in surgical units of the hospital, as well as issued a corresponding order. A key element that allowed to reduce excessive use of antibiotics and thus to decrease the incidence of antibiotic resistance and to improve the effectiveness of antibacterial therapy was the development and implementation of the Instruction on the procedure of antibiotic prophylaxis and antimicrobial therapy in the units of the Clinical hospital «Feofaniia». According to the Instruction, the administration of antibacterial therapy is allowed only after stratification of a patient, stratification of the group of infections and determination of the nature of the infection. In addition, on the basis of microbiological passports of surgical units, there were offered the most appropriate regimens of antibacterial drug administration. The aim of our publication is the spread of the experience of a limited and prudent use of antibiotics, as well as promoting wide public discussion of the guidelines developed by us, and documents for their further improvement.