Long-Term Impact of an Educational Antimicrobial Stewardship Program on Management of Patients with Hematological Diseases
| Autor: | Nancy Rodríguez-Torres, Ana Belén Guisado-Gil, Germán Peñalva, José-Antonio Pérez-Simón, José González-Campos, José Miguel Cisneros, Juan Luis Reguera-Ortega, José Antonio Lepe, I Espigado, José Molina, Eduardo Rodríguez-Arbolí, Manuela Aguilar-Guisado, José Francisco Falantes-González, María Isabel Montero-Cuadrado, María Victoria Gil-Navarro |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
Microbiology (medical) medicine.medical_specialty 030106 microbiology Population hematologic diseases Biochemistry Microbiology Article 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Antimicrobial stewardship Pharmacology (medical) 030212 general & internal medicine General Pharmacology Toxicology and Pharmaceutics Medical prescription bacteremia education education.field_of_study business.industry Mortality rate Incidence (epidemiology) candidemia lcsh:RM1-950 Antimicrobial medicine.disease antimicrobial stewardship Infectious Diseases Hematological Diseases lcsh:Therapeutics. Pharmacology Bacteremia anti-infective agents business |
| Zdroj: | Antibiotics, Vol 10, Iss 136, p 136 (2021) Antibiotics Volume 10 Issue 2 |
| ISSN: | 2079-6382 |
| Popis: | Antimicrobial stewardship programs (ASPs) in hematological patients are especially relevant. However, information about ASPs in this population is scarce. For 11 years, we quarterly assessed antimicrobial consumption and incidence and death rates of multidrug-resistant (MDR) bloodstream infections (BSI) in the hematology Department. Healthcare activity indicators were also monitored yearly. We performed an interrupted time-series analysis. Antimicrobials showed a sustained reduction with a relative effect of &minus 62.3% (95% CI &minus 84.5 to &minus 40.1) nine years after the inception of the ASP, being especially relevant for antifungals (relative effect &minus 80.4%, &minus 90.9 to &minus 69.9), quinolones (relative effect &minus 85.0%, &minus 102.0 to &minus 68.1), and carbapenems (relative effect &minus 68.8%, &minus 126.0 to &minus 10.6). Incidence density of MDR BSI remained low and stable (mean 1.10 vs. 0.82 episodes per 1000 occupied bed days for the pre-intervention and the ASP period, respectively) with a quarterly percentage of change of &minus 0.3% (95% CI &minus 2.0 to 1.4). Early and late mortality of MDR BSI presented a steady trend (quarterly percentage of change &minus 0.7%, 95% CI &minus 1.7 to 0.3 and &minus 0.6%, 95% CI &minus 1.5 to 0.3, respectively). Volume and complexity of healthcare activity increased over the years. The ASP effectively achieved long-term reductions in antimicrobial consumption and improvements in the prescription profile, without increasing the mortality of MDR BSI. |
| Databáze: | OpenAIRE |
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