Staphylococcus aureus - selective reporting of antibiogram results and its impact on antibiotic use: Interventional study with a reference group on the effect of switching from non-selective to selective antibiotic reporting

Autor: Lutz Briedigkeit, Franka Lestin-Bernstein, Kristina Biedermann, Ramona Harberg, Ingo Schumacher, Oliver Heese
Rok vydání: 2020
Předmět:
Microbiology (medical)
Male
medicine.medical_specialty
Staphylococcus aureus
Time Factors
medicine.drug_class
Antibiotics
Cefazolin
Infectious and parasitic diseases
RC109-216
Microbial Sensitivity Tests
Staphylococcus aureus infection
Selective reporting of susceptibility testing
Recommended daily dose (RDD)
Tertiary Care Centers
Antimicrobial Stewardship
Internal medicine
Cefalexin
Germany
medicine
Antimicrobial stewardship
Electronic Health Records
Humans
Pharmacology (medical)
Days of therapy (DOT)
Aged
business.industry
Research
Staphylococcus aureus bacteremia (SAB)
Public Health
Environmental and Occupational Health
Clindamycin
Staphylococcal Infections
medicine.disease
Anti-Bacterial Agents
Selective antibiogram
Infectious Diseases
Bacteremia
Antimicrobial stewardship (AMS)
Gentamicin
Female
Flucloxacillin
business
medicine.drug
Zdroj: Antimicrobial Resistance and Infection Control
Antimicrobial Resistance and Infection Control, Vol 10, Iss 1, Pp 1-13 (2021)
ISSN: 2047-2994
Popis: Background Antimicrobial stewardship (AMS) strategies worldwide focus on optimising the use of antibiotics. Selective susceptibility reporting is recommended as an effective AMS tool although there is a lack of representative studies investigating the impact of selective susceptibility reporting on antibiotic use. The aim of this study was to investigate the impact of selective susceptibility reporting of Staphylococcus aureus (S. aureus) on antibiotic consumption. Enhancing the use of narrow-spectrum beta-lactam antibiotics such as flucloxacillin/cefazolin/cefalexin is one of the main goals in optimising antibiotic therapy of S. aureus infections. Methods This interventional study with control group was conducted at a tertiary care hospital in Germany. During the one-year interventional period susceptibility reports for all methicillin-sensitive S. aureus (MSSA) were restricted to flucloxacillin/cefazolin/cefalexin, trimethoprim-sulfamethoxazole, clindamycin, gentamicin and rifampin/fosfomycin, instead of reporting all tested antibiotics. The impact of implementing selective reporting was analysed by monitoring total monthly antibiotic consumption in our hospital and in a reference hospital (recommended daily dose/100 occupied bed days: RDD/100 BD), as well as on an individual patient level by analysing days of therapy adjusted for bed days (DOT/ 100 BD) for patients with S. aureus bacteremia (SAB) and respectively skin and soft tissue infections (SSTI). Results MSSA-antibiograms were acquired for 2836 patients. The total use of narrow-spectrum beta-lactams more than doubled after implementing selective reporting (from 1.2 to 2.8 RDD/100 BD, P Conclusions As narrow-spectrum beta-lactams are not widely used for other infections, their increase in the overall consumption of the entire hospital was a strong indicator that selective reporting guided clinicians to an optimised antibiotic therapy of S. aureus infections. On a patient level, this assumption was verified by a significant improved treatment of S. aureus infections in the subgroups of SAB and SSTI. As useful AMS tool, we recommend implementing selective reporting rules into the national/international standards for susceptibility reporting.
Databáze: OpenAIRE
Externí odkaz: