Letter to the Editor
Rational use of antimicrobials in home hospitalisation
Uso racional de antimicrobianos en hospitalización a domicilio
Manuel Mirón-Rubio
Unidad de Hospitalización a Domicilio, Hospital Universitario de Torrejón, Torrejón de Ardoz, Madrid, Spain
Read
850
Timeswas read the article
199
Total PDF
651
Total HTML
Share statistics
array:24 [ "pii" => "S2529993X21000307" "issn" => "2529993X" "doi" => "10.1016/j.eimce.2020.11.017" "estado" => "S300" "fechaPublicacion" => "2021-04-01" "aid" => "2339" "copyright" => "Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica" "copyrightAnyo" => "2020" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Enferm Infecc Microbiol Clin. 2021;39:217-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0213005X20304109" "issn" => "0213005X" "doi" => "10.1016/j.eimc.2020.11.008" "estado" => "S300" "fechaPublicacion" => "2021-04-01" "aid" => "2339" "copyright" => "Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Enferm Infecc Microbiol Clin. 2021;39:217-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "es" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta al Editor</span>" "titulo" => "Uso racional de antimicrobianos en hospitalización a domicilio" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "217" "paginaFinal" => "218" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Rational use of antimicrobials in home hospitalisation" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Manuel Mirón-Rubio" "autores" => array:1 [ 0 => array:2 [ "nombre" => "Manuel" "apellidos" => "Mirón-Rubio" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2529993X21000307" "doi" => "10.1016/j.eimce.2020.11.017" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2529993X21000307?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213005X20304109?idApp=UINPBA00004N" "url" => "/0213005X/0000003900000004/v1_202104030817/S0213005X20304109/v1_202104030817/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2529993X21000319" "issn" => "2529993X" "doi" => "10.1016/j.eimce.2020.11.018" "estado" => "S300" "fechaPublicacion" => "2021-04-01" "aid" => "2349" "copyright" => "Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Enferm Infecc Microbiol Clin. 2021;39:218-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Reply to “Rational use of antimicrobials in home hospitalization”" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "218" "paginaFinal" => "219" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Respuesta a «Uso racional de antimicrobianos en hospitalización a domicilio»" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "David Sánchez Fabra, Adriana Ger Buil, Isabel Torres Courchoud, Teresa Rubio Obanos" "autores" => array:4 [ 0 => array:2 [ "nombre" => "David" "apellidos" => "Sánchez Fabra" ] 1 => array:2 [ "nombre" => "Adriana" "apellidos" => "Ger Buil" ] 2 => array:2 [ "nombre" => "Isabel" "apellidos" => "Torres Courchoud" ] 3 => array:2 [ "nombre" => "Teresa" "apellidos" => "Rubio Obanos" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0213005X20304201" "doi" => "10.1016/j.eimc.2020.11.017" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213005X20304201?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2529993X21000319?idApp=UINPBA00004N" "url" => "/2529993X/0000003900000004/v1_202104030716/S2529993X21000319/v1_202104030716/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S2529993X21000642" "issn" => "2529993X" "doi" => "10.1016/j.eimce.2020.08.003" "estado" => "S300" "fechaPublicacion" => "2021-04-01" "aid" => "2276" "copyright" => "Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Enferm Infecc Microbiol Clin. 2021;39:216-7" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Concerns about COVID-19 and tuberculosis in Brazil: Social and public health impacts" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "216" "paginaFinal" => "217" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Preocupaciones sobre COVID-19 y tuberculosis en Brasil: impactos sociales y de salud pública" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 683 "Ancho" => 2341 "Tamanyo" => 67682 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Distribution of the registered cases (in the whole year of 2019) and deaths (in the whole year of 2018) of Tuberculosis in Brazil and (B) Distribution of registered cases and deaths caused by COVID-19 in Brazil (from February 26th to August 4th, 2020).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Victoria Stadler Tasca Ribeiro, João Paulo Telles, Felipe Francisco Tuon" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Victoria Stadler Tasca" "apellidos" => "Ribeiro" ] 1 => array:2 [ "nombre" => "João Paulo" "apellidos" => "Telles" ] 2 => array:2 [ "nombre" => "Felipe Francisco" "apellidos" => "Tuon" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2529993X21000642?idApp=UINPBA00004N" "url" => "/2529993X/0000003900000004/v1_202104030716/S2529993X21000642/v1_202104030716/en/main.assets" ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Rational use of antimicrobials in home hospitalisation" "tieneTextoCompleto" => true "saludo" => "Dear Editor," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "217" "paginaFinal" => "218" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "Manuel Mirón-Rubio" "autores" => array:1 [ 0 => array:3 [ "nombre" => "Manuel" "apellidos" => "Mirón-Rubio" "email" => array:1 [ 0 => "mmrubio@torrejonsalud.com" ] ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Unidad de Hospitalización a Domicilio, Hospital Universitario de Torrejón, Torrejón de Ardoz, Madrid, Spain" "identificador" => "aff0005" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Uso racional de antimicrobianos en hospitalización a domicilio" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">In the article published by Sánchez Fabra et al.,<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> the authors draw attention to the margin for improvement in the quality of prescribing of antimicrobial agents in hospital at home (HaH) for patients with pneumonia, mainly in terms of de-escalation (reduction of the antimicrobial spectrum) and sequential therapy (change from intravenous to oral).</p><p id="par0010" class="elsevierStylePara elsevierViewall">For some years now, a range of studies have drawn attention to the inappropriate use of outpatient parenteral antimicrobial treatment,<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2–6</span></a> particularly in care models in which the clinical monitoring and maintenance of parenteral therapy is not in the hands of experienced professionals, but rather depends on outsourced agencies or services used in an attempt to facilitate early discharge from hospitals. Moreover, several publications have also warned of an unusually high number of complications of outpatient intravenous treatment, particularly associated with venous access.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">The hospital-based model of HaH does not appear to be exposed to the level of risk of inappropriate antimicrobial treatment and complications that other studies describe.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> However, as Sánchez Fabra et al point out, the fact that about half of the patients in the study did not have de-escalation or sequential therapy when indicated is no trivial matter. Analysing this situation and adapting to the recommendations of the guidelines is a requirement for any healthcare model -no less for hospital at home- and it has been shown that there is room for improvement.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Nonetheless, the study leaves unanswered questions that deserve a more detailed analysis. As the authors argue, there could be circumstances not included in the medical records which might require IV antibiotic therapy to continue for longer than recommended in the clinical practice guidelines. As far as de-escalation is concerned, at times, reducing the spectrum of antimicrobial activity can mean the use of drugs with greater frequency of administration, and this may be a limitation, depending on the organisation, resources and coverage hours of the hospital-at-home units. That may not be a sufficient reason to continue an antibiotic with a higher spectrum of activity, but the alternative may sometimes be for the patient to remain in hospital, an option which is also not without risk.</p><p id="par0025" class="elsevierStylePara elsevierViewall">In addition, the authors observed that patients coming from Accident and Emergency (A&E) had a better quality of prescription (request for tests, adequacy of the prescription, de-escalation, sequential therapy, duration of treatment) than those who came from the ward. This difference would be worrying if the assignment to a conventional admission or hospital at home directly from A&E had been random. However, this was not the case, and the fact that the patients admitted directly from A&E were younger and had less comorbidity does not allow us to conclude that the differences are due to the care by a single physician (for the HaH) being more ideal than the care by two (ward and HaH). As the authors argue, in the case of readmissions at 30 days, the aspect that seemed to weigh most heavily on the quality of the prescription were the characteristics of the patient and not the dynamics of the HaH.</p><p id="par0030" class="elsevierStylePara elsevierViewall">The study does not specify whether or not the mean hospital stay of 2.5 days included patients admitted directly to hospital at home from A&E. If they were not included, the stay was short enough for the HaH practitioner to have made the decision about de-escalation or sequential therapy with the same diligence as previously non-hospitalised patients, and would be another argument in favour of the differences observed being due to the profile of the patients. If the calculation of the mean stay included patients admitted from A&E (in which case the mean stay would be longer, considering only conventionally hospitalised patients), the deficiency in the treatment could have already occurred on the inpatient ward.</p><p id="par0035" class="elsevierStylePara elsevierViewall">In summary, this is a necessary article alerting to the need to implement programmes for rational use of antimicrobials in hospital at home with the same rigour as in hospitals.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Mirón-Rubio M. Uso racional de antimicrobianos en hospitalización a domicilio. Enferm Infecc Microbiol Clin. 2021;39:217–218.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:8 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Manejo antibiótico en neumonía adquirida en la comunidad en la hospitalización a domicilio: ¿Hay margen de mejora? [published online ahead of print 5]" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "D. Sánchez Fabra" 1 => "A. Ger Buil" 2 => "I. Torres Courchoud" 3 => "R. Martínez-Murgui" 4 => "M.T. Matía Sanz" 5 => "I. Fiteni Mera" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:3 [ "tituloSerie" => "Enferm Infecc Microbiol Clin" "fecha" => "2020" "paginaInicial" => "2020" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical and economic impact of implementing OVIVA criteria on patients with bone and joint infections in outpatient parenteral antimicrobial therapy" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Marks" 1 => "L.C.K. Bell" 2 => "I. Jones" 3 => "T. Rampling" 4 => "K. Kranzer" 5 => "S. Morris-Jones" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/cid/ciz991" "Revista" => array:7 [ "tituloSerie" => "Clin Infect Dis" "fecha" => "2020" "volumen" => "71" "paginaInicial" => "207" "paginaFinal" => "210" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31603189" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0302283818304731" "estado" => "S300" "issn" => "03022838" ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Outpatient parenteral antimicrobial therapy and antimicrobial stewardship: challenges and checklists" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M. Gilchrist" 1 => "R.A. Seaton" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/jac/dku517" "Revista" => array:6 [ "tituloSerie" => "J Antimicrob Chemother" "fecha" => "2015" "volumen" => "70" "paginaInicial" => "965" "paginaFinal" => "970" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25538169" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Impact of a multidisciplinary team review of potential outpatient parenteral antimicrobial therapy prior to discharge from an academic medical center" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "B.H. Heintz" 1 => "J. Halilovic" 2 => "C.L. Christensen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1345/aph.1Q240" "Revista" => array:6 [ "tituloSerie" => "Ann Pharmacother" "fecha" => "2011" "volumen" => "45" "paginaInicial" => "1329" "paginaFinal" => "1337" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21990938" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sequential intravenous-to-oral outpatient antibiotic therapy for MRSA bacteraemia: one step closer" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "S.C.J. Jorgensen" 1 => "A.M. Lagnf" 2 => "S. Bhatia" 3 => "M.D. Shamim" 4 => "M.J. Rybak" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/jac/dky452" "Revista" => array:6 [ "tituloSerie" => "J Antimicrob Chemother" "fecha" => "2019" "volumen" => "74" "paginaInicial" => "489" "paginaFinal" => "498" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30418557" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Inappropriateness of intravenous antibiotic prescriptions at hospital discharge at a tertiary care hospital in Thailand" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "T. Mahatumarat" 1 => "N. Pinmanee" 2 => "W. Injai" 3 => "R. Chaiwarith" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2147/DHPS.S221430" "Revista" => array:7 [ "tituloSerie" => "Drug Healthc Patient Saf" "fecha" => "2019" "volumen" => "11" "paginaInicial" => "125" "paginaFinal" => "129" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31908542" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S1470204505704721" "estado" => "S300" "issn" => "14702045" ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Vascular access complications during outpatient parenteral antimicrobial therapy at home: a retrospective cohort study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "N.K. Shrestha" 1 => "J. Shrestha" 2 => "A. Everett" 3 => "D. Carroll" 4 => "S.M. Gordon" 5 => "R.S. Butler" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/jac/dkv344" "Revista" => array:7 [ "tituloSerie" => "J Antimicrob Chemother" "fecha" => "2016" "volumen" => "71" "paginaInicial" => "506" "paginaFinal" => "512" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26510718" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0302283816302494" "estado" => "S300" "issn" => "03022838" ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Intravenous antimicrobial therapy in the hospital-at-home setting: data from the Spanish Outpatient Parenteral Antimicrobial Therapy Registry" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Mirón-Rubio" 1 => "V. González-Ramallo" 2 => "O. Estrada-Cuxart" 3 => "P. Sanroma-Mendizábal" 4 => "A. Segado-Soriano" 5 => "A. Mujal-Martínez" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2217/fmb.15.141" "Revista" => array:6 [ "tituloSerie" => "Future Microbiol" "fecha" => "2016" "volumen" => "11" "paginaInicial" => "375" "paginaFinal" => "390" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26974259" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/2529993X/0000003900000004/v1_202104030716/S2529993X21000307/v1_202104030716/en/main.assets" "Apartado" => array:4 [ "identificador" => "66012" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/2529993X/0000003900000004/v1_202104030716/S2529993X21000307/v1_202104030716/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2529993X21000307?idApp=UINPBA00004N" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 October | 4 | 0 | 4 |
| 2024 September | 29 | 15 | 44 |
| 2024 August | 14 | 7 | 21 |
| 2024 July | 5 | 1 | 6 |
| 2024 June | 9 | 3 | 12 |
| 2024 May | 11 | 1 | 12 |
| 2024 April | 9 | 1 | 10 |
| 2024 March | 19 | 8 | 27 |
| 2024 February | 8 | 5 | 13 |
| 2024 January | 13 | 2 | 15 |
| 2023 December | 17 | 2 | 19 |
| 2023 November | 19 | 5 | 24 |
| 2023 October | 11 | 4 | 15 |
| 2023 September | 11 | 2 | 13 |
| 2023 August | 5 | 0 | 5 |
| 2023 July | 8 | 1 | 9 |
| 2023 June | 21 | 2 | 23 |
| 2023 May | 47 | 6 | 53 |
| 2023 April | 33 | 0 | 33 |
| 2023 March | 15 | 2 | 17 |
| 2023 February | 12 | 1 | 13 |
| 2023 January | 52 | 4 | 56 |
| 2022 December | 14 | 4 | 18 |
| 2022 November | 15 | 4 | 19 |
| 2022 October | 12 | 7 | 19 |
| 2022 September | 21 | 13 | 34 |
| 2022 August | 11 | 10 | 21 |
| 2022 July | 8 | 7 | 15 |
| 2022 June | 7 | 6 | 13 |
| 2022 May | 10 | 3 | 13 |
| 2022 April | 7 | 6 | 13 |
| 2022 March | 15 | 8 | 23 |
| 2022 February | 11 | 6 | 17 |
| 2022 January | 46 | 4 | 50 |
| 2021 December | 38 | 6 | 44 |
| 2021 November | 9 | 15 | 24 |
| 2021 October | 13 | 8 | 21 |
| 2021 September | 1 | 1 | 2 |
| 2021 April | 41 | 19 | 60 |
Show all
