Does a reduction in antibiotic consumption always represent a favorable outcome from an intervention program on prescribing practice?

Bantar, Carlos; Franco, Diego; Heft, Claudia; Vesco, Eduardo; Arango, Carina; Izaguirre, Mariano; Oliva, María Eugenia

doi:10.1016/j.ijid.2005.05.012

Cited by 8 publications

(5 citation statements)

References 11 publications

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“…In an Argentine multi-step ABS programme involving training and formulary restriction, antimicrobial consumption could be reduced from 43 to 28 DDD/100 patient-days, resulting in substantial savings (>900.000 USD) over 18 months. During the training period a significant increase in the rate of prescriptions based upon microbiology results (27–63 %) was found, and use of ceftriaxone and carbapenems subsequently more than halved [ 30 ]. The combination of one-on-one education (academic detailing) and special review of orders for either levofloxacin or ceftazidime was also seen as a highly effective method for reducing inadequate antibiotic use.…”

Section: Recommendations Of the Guidelinementioning

confidence: 99%

Strategies to enhance rational use of antibiotics in hospital: a guideline by the German Society for Infectious Diseases

et al. 2016

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IntroductionIn the time of increasing resistance and paucity of new drug development there is a growing need for strategies to enhance rational use of antibiotics in German and Austrian hospitals. An evidence-based guideline on recommendations for implementation of antibiotic stewardship (ABS) programmes was developed by the German Society for Infectious Diseases in association with the following societies, associations and institutions: German Society of Hospital Pharmacists, German Society for Hygiene and Microbiology, Paul Ehrlich Society for Chemotherapy, The Austrian Association of Hospital Pharmacists, Austrian Society for Infectious Diseases and Tropical Medicine, Austrian Society for Antimicrobial Chemotherapy, Robert Koch Institute.Materials and methodsA structured literature research was performed in the databases EMBASE, BIOSIS, MEDLINE and The Cochrane Library from January 2006 to November 2010 with an update to April 2012 (MEDLINE and The Cochrane Library). The grading of recommendations in relation to their evidence is according to the AWMF Guidance Manual and Rules for Guideline Development.ConclusionThe guideline provides the grounds for rational use of antibiotics in hospital to counteract antimicrobial resistance and to improve the quality of care of patients with infections by maximising clinical outcomes while minimising toxicity. Requirements for a successful implementation of ABS programmes as well as core and supplemental ABS strategies are outlined. The German version of the guideline was published by the German Association of the Scientific Medical Societies (AWMF) in December 2013.

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Section: Recommendations Of the Guidelinementioning

confidence: 99%

Strategies to enhance rational use of antibiotics in hospital: a guideline by the German Society for Infectious Diseases

et al. 2016

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“…However, reports regarding efforts to reduce antibiotic usage have mainly focused on interventions for in-hospital prescriptions and injectables. [5][6][7][8][9][15][16][17][18][19]24,25 In addition, no reports are examining the effects of interventions on outpatient prescriptions. This is the first report to evaluate the effects of a revised antibiotic formulary on both in-and out-hospital prescriptions to the best of our knowledge.…”

Section: Discussionmentioning

confidence: 99%

“…16 Other studies have also shown that optimising and reducing antibiotic usage strongly improve pathogens' susceptibility. [17][18][19] These data suggest that reducing antibiotic consumption, especially broad-spectrum antibiotics, is a useful countermeasure against AMR.…”

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confidence: 95%

Revised hospital antibiotic formulary reduces antimicrobial consumption and promotes a shift towards narrow‐spectrum antibiotic usage

et al. 2021

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Antimicrobial resistance (AMR) of microorganisms to antibiotics has been declared a serious threat to global public health and an issue that requires intervention across all social and government sectors.The emergence and spread of AMR threaten our ability to treat common infectious diseases, resulting in prolonged illness, disability, increasing healthcare costs and higher mortality rates. 1 In April 2016, the Government of Japan devised a national action plan to intensify efforts and measures against AMR. 2 The plan presented priorities to be implemented over the next 5 years to promote measures against AMR in the country. Approximately 90% of antimicrobials consumed in Japan are oral medications, which are prescribed to patients over an extensive age range, whereas injectable antibiotics

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“…However, developing countries may go through periods of deficient healthcare conditions that affect the availability of antimicrobial agents. Under these conditions, a reduction in antimicrobial consumption may not represent a favorable outcome[13].…”

Section: Introductionmentioning

confidence: 99%

“…Under these conditions, a reduction in antimicrobial consumption may not represent a favorable outcome [13]. technologies, and poor adherence to treatment [16].…”

Section: Introductionmentioning

confidence: 99%

Addressing the aftermath of the COVID-19 pandemic: A quality improvement collaborative to optimize the use of antibacterials in Argentine Intensive Care Units

Jorro-Barón,

Loudet,

Cornistein

et al. 2023

Preprint

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Background: Reducing antimicrobial resistance is a global priority that become even more important after the COVID-19 pandemic. To date there is a scarce volume of evidence from antimicrobial stewardship programs from less resourced settings where this phenomenon is bigger. Our aim was to improve the quality of antibacterials prescription in intensive care units (ICUs) in a middle-income country. Methods: We established a quality improvement collaborative (QIC) model involving nine ICUs over an 11-month period, with a 16-week baseline (BP) and 32-week Intervention (IP) periods. Our co-designed intervention package included audits and feedback on antibacterial use, facility-specific treatment guidelines, antibacterial timeouts, pharmacy-based interventions, and education. The intervention was delivered in two learning sessions with three action periods, along with coaching support and basic quality improvement training. Results: We enrolled 912 patients, with 357 in baseline period (BP) and 555 in implementation period (IP). The latter had higher APACHE II (17 (12, 21) vs. 15 (11, 20); p=0.036) and SOFA scores (6 (4, 9) vs. 5 (3, 8); p=0.006), sepsis (36.1% vs. 31.6%, p<0.001), and septic shock (40.0% vs. 33.8%, p<0.001). Days of antibacterial therapy were similar between groups (IP 1112.2, BP 1133.4, RR 0.98 (0.95-1.02); p=0.2973) and the antibacterial Daily Define Dose was lower in IP group (IP, 1193.0; BP, 1301.0; RR, 0.92 (0.89, 0.95); p=0.0001). The rate of adequate antibacterial adjustment was higher during the IP (62.0% vs. 45.3%, p<0.001). We observed a lower rate of ventilation-associated pneumonia and catheter-associated urinary tract infections related to multidrug-resistant organisms (MDRO) in the IP. There was a noticeable improvement in the Infection Prevention and Control (IPC) Assessment Framework compared to baseline. Conclusion: The implementation of a post pandemic antimicrobial stewardship program in ICUs via a QIC demonstrated success in improving antibacterials utilization, reducing HAIs related to MDRO while also enhancing IPC measures.

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Does a reduction in antibiotic consumption always represent a favorable outcome from an intervention program on prescribing practice?

Cited by 8 publications

References 11 publications

Strategies to enhance rational use of antibiotics in hospital: a guideline by the German Society for Infectious Diseases

Strategies to enhance rational use of antibiotics in hospital: a guideline by the German Society for Infectious Diseases

Revised hospital antibiotic formulary reduces antimicrobial consumption and promotes a shift towards narrow‐spectrum antibiotic usage

Addressing the aftermath of the COVID-19 pandemic: A quality improvement collaborative to optimize the use of antibacterials in Argentine Intensive Care Units

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