A broad-spectrum beta-lactam-sparing stewardship program in a middle-income country public hospital: antibiotic use and expenditure outcomes and antimicrobial susceptibility profiles

“…However, clinical studies have demonstrated a good cost-effectiveness relationship if automated cultures are implemented [22]. Considering the direct impact of ASP on cost savings and patient outcomes [9], the importance of close cooperation between the clinical microbiology laboratory and antimicrobial stewardship teams cannot be underestimated.…”

Section: Discussionmentioning

confidence: 99%

“…This study was conducted between January 2017 and July 2017 (conventional method period [CMP]) and August 2017 to December 2017 (automated method period [AMP]). This hospital has an active ASP and diagnostic stewardship programme that has been described in previous publications [9][10][11].…”

Section: Settingmentioning

confidence: 99%

The impact of VITEK 2 implementation for identification and susceptibility testing of microbial isolates in a Brazilian public hospital

Decarli

Nascimento

Esteves

et al. 2022

Journal of Medical Microbiology

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Introduction. The use of automated systems in identification and susceptibility tests can improve antimicrobial therapy, and positively impact clinical outcomes with a decrease in antimicrobial resistance, hospitalization time, costs, and mortality. Aim. The aim of this study was to evaluate the clinical impact of an automated method for identification and susceptibility testing of microbial isolates. Methodology. This was a retrospective cross-sectional study aimed to analyse the results before and after the implementation period of a VITEK 2 system in a Brazilian university hospital. Based on data from medical records, patients with a positive culture of clinical samples from January to July 2017 (conventional method) and from August to December 2017 (automated method) were included in this study. Demographic data, hospitalization time, time interval between culture collection and results, culture results and site, susceptibility profile, minimum inhibitory concentration, and outcome data were evaluated. Chi-square and Fischer’s tests were used in the analysis. Results. Of the total samples, 836 were considered valid by the inclusion criteria, with 219 patients before VITEK 2 system implementation group and 545 in the post-implementation group. The comparison between the two periods showed a reduction of 25 % of the time to culture reports, a decrease of 33.5 to 17.0 days of hospitalization, and a reduction in mortality from 44.3–31.0 %, respectively. Conclusion. The VITEK 2 system provided early access to appropriate antimicrobial therapy for patients and effected a positive clinical impact with a reduction in mortality and hospitalization time.

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“…Similarly, a study conducted in Japan during 2016 -2013 showed that the na-tional stewardship program reduced antibiotic use by 50% in hospitalized patients (13). In Brazil, the implementation of the stewardship program resulted in 11.3% reduction in antibiotic use and 53% reduction in treatment costs (14). The stewardship program was also reported to be effective in Israel, and a study indicated that during 2012 -2017, antimicrobial use declined significantly (15).…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Logical Use of Parenteral Antibiotics Before and After the Implementation of the Stewardship Program

Janbakhsh

Naghibifar

Eskandari

et al. 2021

J Kermanshah Univ Med Sci

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Background: Excessive use of antibiotics has led to drug resistance. As such, stewardship programs are implemented to control antibiotic use in hospitalized patients. Objectives: The present study aimed to evaluate the frequency of antibiotic use after the implementation of the stewardship program. Methods: This retrospective study was conducted on the patients admitted to Imam Reza Hospital in Kermanshah, Iran during 2017 - 2018. The required data were extracted from the pharmaceutical ward of the hospital. Data analysis was performed in SPSS version 24. Results: The median per capita numerical and Rial consumption of caspofungin and linezolid antibiotics increased after the implementation of the stewardship plan, while the consumption of imipenem, amphotericin, teicoplanin, colistin, meropenem, voriconazole, and vancomycin was observed to decrease. In addition, the median per capita of the numerical use of caspofungin and linezolid increased in the surgery ward, intensive care unit (ICU), and internal medicine ward after the implementation of the stewardship plan. On the other hand, a reduction was observed in the use of amphotericin, colistin, voriconazole, and vancomycin in only one ward. The use of meropenem and teicoplanin also increased in the surgery ward and decreased in the other wards, while the use of imipenem increased in the ICU after implementing the plan and decreased in the other wards. The median use of antibiotics was not considered significant in the internal medicine ward, surgery ward, and ICU before and after implementing the stewardship program (P > 0.05). Conclusions: According to the results, antibiotic use slightly decreased after the implementation of the stewardship program. However, an increase was also observed in antibiotic prescription in some cases, which indicated that the stewardship program was not implemented properly, and no changes occurred in antibiotics prescription.

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A broad-spectrum beta-lactam-sparing stewardship program in a middle-income country public hospital: antibiotic use and expenditure outcomes and antimicrobial susceptibility profiles

Cited by 14 publications

References 37 publications

Impact of an antimicrobial stewardship program in a COVID-19 reference hospital according to the AWaRe classification

Impact of an antimicrobial stewardship program in a COVID-19 reference hospital according to the AWaRe classification

The impact of VITEK 2 implementation for identification and susceptibility testing of microbial isolates in a Brazilian public hospital

Comparison of the Logical Use of Parenteral Antibiotics Before and After the Implementation of the Stewardship Program

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