Impact of antimicrobial stewardship intervention in clean and clean-contaminated surgical procedures at a Vietnamese national hospital.

Autor: Phan QTN; Department of Clinical Pharmacy, Faculty of Pharmacy, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam., Le TD; Thong Nhat Hospital, Ho Chi Minh City, Vietnam., Do QK; Thong Nhat Hospital, Ho Chi Minh City, Vietnam., Pham HTT; Thong Nhat Hospital, Ho Chi Minh City, Vietnam., Tran MTP; Thong Nhat Hospital, Ho Chi Minh City, Vietnam., Vo TD; Department of Internal Medicine, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam., Le LV; Thong Nhat Hospital, Ho Chi Minh City, Vietnam., Nguyen TM; Thong Nhat Hospital, Ho Chi Minh City, Vietnam., Tran NQ; Thong Nhat Hospital, Ho Chi Minh City, Vietnam., Nguyen NTY; Thong Nhat Hospital, Ho Chi Minh City, Vietnam., Nguyen HT; Thong Nhat Hospital, Ho Chi Minh City, Vietnam., Bui QTH; Department of Clinical Pharmacy, Faculty of Pharmacy, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.; Thong Nhat Hospital, Ho Chi Minh City, Vietnam.
Jazyk: angličtina
Zdroj: Tropical medicine & international health : TM & IH [Trop Med Int Health] 2022 Apr; Vol. 27 (4), pp. 454-462. Date of Electronic Publication: 2022 Mar 01.
DOI: 10.1111/tmi.13738
Abstrakt: Objectives: We investigated the characteristics of prophylactic antimicrobial use in clean and clean-contaminated surgical procedures and assessed the efficacy of a prophylactic antimicrobial stewardship intervention at Thong Nhat Hospital, Ho Chi Minh City, Vietnam.
Methods: A cross-sectional study was conducted on 354 patients who underwent either clean or clean-contaminated surgical procedures at Thong Nhat Hospital. Eligible patients were classified with respect to three periods of intervention from 2017 to 2020. Data collection included surgical procedures, patient characteristics, and prophylactic antimicrobial usage. We determined the efficacy of antimicrobial stewardship intervention based on comparisons among the primary outcome (the appropriateness of prophylactic antimicrobials) and secondary outcomes (postoperative antimicrobial prophylaxis (AP) prolongation, length of postoperative hospital stay, and cost of antimicrobials).
Results: The mean age of patients in periods 1, 2, and 3 was 54.5 ± 16.6, 50.2 ± 16.5, and 52.8 ± 17.3 years, respectively, with an overall male/female ratio of 1.1/1. No significant differences were detected in basic patient characteristics during the three periods. Majority of the surgical procedures were clean (56%-59%) and scheduled (85%-86%). Prophylactic antimicrobial stewardship intervention enhanced AP appropriateness (by 12.7%, 12.7%, and 39.0% in periods 1, 2, and 3, respectively, p < 0.001), decreased postoperative prophylactic antimicrobial duration [3.0 (0-6), 1.5 (0-5), and 0.0 (0-1) days, respectively, p < 0.001], and reduced average antimicrobial expenses (p < 0.001).
Conclusions: The prophylactic antimicrobial stewardship interventions introduced at Thong Nhat Hospital had several positive impacts on the appropriateness of prophylactic antimicrobial use and treatment costs.
(© 2022 John Wiley & Sons Ltd.)
Databáze: MEDLINE
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