Non-Restrictive Antimicrobial Stewardship Program in a General and Emergency Surgery Unit
| Autor: | Massimo Sartelli, Alessandro Chiodera, Francesco M. Labricciosa, Jessica Bellesi, Loredana Scoccia, Maria Rita Mazzoccanti, Bianca Gentilozzi, Giorgia Scaloni |
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| Rok vydání: | 2016 |
| Předmět: |
Male
0301 basic medicine Microbiology (medical) Imipenem medicine.medical_specialty 030106 microbiology Microbial Sensitivity Tests Unnecessary Procedures Meropenem 03 medical and health sciences 0302 clinical medicine Anti-Infective Agents Levofloxacin Internal medicine Drug Resistance Bacterial medicine Humans Antimicrobial stewardship 030212 general & internal medicine Dosing Practice Patterns Physicians' Program Development Emergency Treatment Retrospective Studies Cilastatin business.industry Retrospective cohort study Middle Aged Antimicrobial Surgery Infectious Diseases General Surgery Female Emergency Service Hospital business medicine.drug |
| Zdroj: | Surgical Infections. 17:485-490 |
| ISSN: | 1557-8674 1096-2964 |
| Popis: | The goal of an antimicrobial stewardship program (ASP) is to prevent the emergence of antimicrobial drug resistance and reduce adverse drug events, optimizing the selection, dosing, and duration of therapy in individual patients.This retrospective study evaluated changes in antimicrobial agent use associated with implementation of an ASP in a general and emergency unit. The pre-intervention and post-intervention periods were defined as July 1, 2013, to December 31, 2013 (pre-intervention) and January 1, 2014, to June 30, 2014 (post-intervention).The mean total monthly antimicrobial use decreased by 18.8%, from 1,074.9 defined daily doses (DDD) per 1,000 patient-days to 873.0 DDD per 1,000 patient-days after the intervention. There was a significant reduction in the use of piperacillin-tazobactam, by 33.7% (p 0.05), in imipenem/cilastatin, by 63.9% (p 0.05), in meropenem by 68.0% (p 0.05), and in levofloxacin by 45.0% (p 0.05) without any negative effect on patient susceptibility to infections. Indeed, patient outcomes, including deaths, length of stay in the hospital, and re-admission within 30 days were not affected.The implementation of an education-based ASP achieved a significant improvement in all antimicrobial agent prescriptions in the surgical unit and a reduction in antimicrobial drug consumption, even when no restrictive measures were implemented. |
| Databáze: | OpenAIRE |
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