Impact of an antimicrobial stewardship and monitoring of infection control bundle in a surgical intensive care unit of a tertiary-care hospital in India
| Autor: | Praveen Kumar-M, Rajesh Gupta, Gurpreet Singh, Aditi M Panditrao, Ajay Salvania, Manisha Biswal, Nusrat Shafiq, Amritpal Kaur Sekhon, Samir Malhotra, Ishita Laroiya, Thakur Deen Yadav, Pallab Ray, Kulbeer Kaur, Vikas Gautam, Vikas Gupta, Hemanth Kumar |
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| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
Microbiology (medical) medicine.medical_specialty Double anaerobic cover Critical Care 030106 microbiology Immunology Developing country India Surgical intensive care unit Microbiology Tertiary Care Centers 03 medical and health sciences Antimicrobial Stewardship 0302 clinical medicine medicine Immunology and Allergy Infection control Antimicrobial stewardship Humans 030212 general & internal medicine DDD/1000PD Infection Control business.industry Incidence (epidemiology) Tertiary care hospital Antimicrobial medicine.disease QR1-502 Pneumonia Antimicrobial metrices Emergency medicine business |
| Zdroj: | Journal of Global Antimicrobial Resistance, Vol 24, Iss, Pp 260-265 (2021) |
| ISSN: | 2213-7173 |
| Popis: | Objectives Antimicrobial stewardship (AMS) in resource-limited settings lacks models that can be readily adapted to their settings. Here we discuss the impact of a combined strategy of AMS and monitoring of infection control practices in a tertiary-care centre of a developing country. Methods This study was undertaken in the surgical unit of a tertiary-care hospital over an 8-month period. In the first 2 months (baseline phase), prospective audit and feedback alone was undertaken, while in the next 6 months (intervention phase) this was supplemented with strategies such as antimicrobial timeout, correction of doses and bundle approach for prevention of hospital-acquired infections. Results A total of 337 patients were included (94 in the baseline phase and 243 in the intervention phase). There was a decrease in days of therapy per 1000 patient-days (1000PD) (1112.3 days vs. 1048.6 days), length of therapy per 1000PD (956 days vs. 936.3 days) and defined daily doses (DDD) per 1000PD for most antimicrobials. A decrease in double cover for Gram-negative infections (9.6% vs. 2.9%) but an increase in double anaerobic cover (4.2% vs. 7.4%) was observed. There was a decrease in the incidence of ventilator-associated pneumonia per 1000 ventilator-days in the intervention phase (46.4 vs. 35.4), whereas central line-associated bloodstream infections per 1000 central line-days remained the same (14.7 vs. 14.8). Conclusion This study shows that implementation of routine AMS activities with monitoring of infection control practices can help decrease overall antimicrobial use. With furtherance of measures to control infection, antimicrobial use may be further curtailed. |
| Databáze: | OpenAIRE |
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