A multicentre cluster-randomized clinical trial to improve antibiotic use and reduce length of stay in hospitals
| Autor: | R J A Diepersloot, W de Bruijn, C van Nieuwkoop, S Nijssen, D Posthouwer, C Jaspers, Jan M. Prins, O Ponteselli, M E van Wolfswinkel, B. M. de Jongh, E B Wilms, Marlies E J L Hulscher, E Mooi, H S A Ammerlaan, B N M Sinha, E Roelofsen, J C Dutilh, C M Verduin, F Snijders, M. M. L. van Rijen, L M Kampschreur, R Brimicombe, M E Sanson, G W D Landman, R Posthuma, M. C. Kallen, C M A Swanink, K R Wilting, R H Streefkerk, P van Hattum, R F J Benus, B Maraha, N Welles, P M G Filius, M Leendertse, C J Miedema, J. W. Van't Wout, P. D. van der Linden, I T M A Overdevest, S U C Sankatsing, T A Ruys, L B S Gelinck, L A Noach, J G den Hollander, S N Bouwman, G J Blaauw, P de Graaf, A Pieffers, R W M A van der Zanden, P Nannan Panday, B J van Dijke, S Teerenstra, M G A van Vonderen, J W Dorigo-Zetsma, P D J Sturm, P C A M Buijtels, D C Melles, E M Kuck, R M T Ladestein, W C van der Zwet, K Hendriks, A Verbon, E H Gisolf, E Nagtegaal, D Huugen, D J Theunissen, Stephanie Natsch, P D Knoester, S W J W Sanders, M.A. Leverstein-van Hall, J L W Pot, N M Delfos, M van den Hurk, Brent C. Opmeer, I van Heijl, E P M van Elzakker, J da Silva-Voorham, M E L Arbouw, K Pogany, J R Lo Ten Foe, M Kuck, A. K. van der Bij, A Muller, F W Sebens, Suzanne E. Geerlings, B Elzer, F. H. Van Tiel |
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| Přispěvatelé: | Medical Microbiology & Infectious Diseases, Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE), Microbes in Health and Disease (MHD), MUMC+: DA KFT Medische Staf (9), RS: FHML non-thematic output, Infectious diseases, AII - Infectious diseases, APH - Quality of Care |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
Microbiology (medical) medicine.medical_specialty 030106 microbiology Hospital mortality law.invention Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18] Feedback 03 medical and health sciences Antimicrobial Stewardship 0302 clinical medicine All institutes and research themes of the Radboud University Medical Center Randomized controlled trial SDG 3 - Good Health and Well-being law Intervention (counseling) medicine Antimicrobial stewardship AcademicSubjects/MED00740 Humans QUALITY Pharmacology (medical) 030212 general & internal medicine Hospital pharmacy Antibiotic use Original Research Pharmacology business.industry STEWARDSHIP Length of Stay Intensive care unit Hospitals Anti-Bacterial Agents Anti-Bacterial Agents/therapeutic use Infectious Diseases lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4] AcademicSubjects/MED00290 Emergency medicine Stewardship business AcademicSubjects/MED00230 |
| Zdroj: | Journal of Antimicrobial Chemotherapy, 76, 1625-1632 Journal of Antimicrobial Chemotherapy The Journal of antimicrobial chemotherapy, 76(6), 1625-1632. Oxford University Press Journal of Antimicrobial Chemotherapy, 76(6), 1625-1632. Oxford University Press Journal of Antimicrobial Chemotherapy, 76, 6, pp. 1625-1632 Journal of antimicrobial chemotherapy, 76(6), 1625-1632. Oxford University Press |
| ISSN: | 0305-7453 |
| DOI: | 10.1093/jac/dkab035 |
| Popis: | Background Various metrics of hospital antibiotic use might assist in guiding antimicrobial stewardship (AMS). Objectives To compare patient outcomes in association with three methods to measure and feedback information on hospital antibiotic use when used in developing an AMS intervention. Methods Three methods were randomly allocated to 42 clusters from 21 Dutch hospitals: (1) feedback on quantity of antibiotic use [DDD, days-of-therapy (DOT) from hospital pharmacy data], versus feedback on (2) validated, or (3) non-validated quality indicators from point prevalence studies. Using this feedback together with an implementation tool, stewardship teams systematically developed and performed improvement strategies. The hospital length of stay (LOS) was the primary outcome and secondary outcomes included DOT, ICU stay and hospital mortality. Data were collected before (February–May 2015) and after (February–May 2017) the intervention period. Results The geometric mean hospital LOS decreased from 9.5 days (95% CI 8.9–10.1, 4245 patients) at baseline to 9.0 days (95% CI 8.5–9.6, 4195 patients) after intervention (P Conclusions The decrease in LOS versus baseline likely reflects improvement in the quality of antibiotic use with the stewardship intervention. While the outcomes with the three methods were otherwise similar, stewardship teams preferred data on the quality over the quantity of antibiotic use. |
| Databáze: | OpenAIRE |
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