Effect of interventions by an antimicrobial stewardship team on clinical course and economic outcome in patients with bloodstream infection

Maeda, Masako; Teratani, Takuma; Seki, Haruka; Ugajin, Kazuhisa; Naito, Yohei; Yoshikawa, Masayuki; Yamanaka, Ayumi; Oto, Yuji; Minemura, Atsuko; Shoji, Hisashi; Ishino, Kozo; Niki, Yoshihito

doi:10.1016/j.jiac.2015.11.004

Cited by 27 publications

(20 citation statements)

References 18 publications

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“…Therefore, a multidisciplinary ICT/AST, including microbiologists, is very important for successful interventions and improving drug susceptibility of the pathogenic bacteria [4,11]. Recommendations regarding appropriate therapies require a broad knowledge of infectious diseases.…”

Section: Resultsmentioning

confidence: 99%

“…Recently, in addition to Infection Control Teams (ICT), interdisciplinary AS teams (AST), comprising infectious disease physicians, pharmacists, nurses and microbiological technicians, have begun to be organized at university and/or tertiary hospitals in Japan and the efficacy of the resulting interventions in preventing inappropriate antibiotic use have been reported for Japanese AST [3][4][5]. In our hospital, a 600-bed tertiary-care university hospital in the city of Sendai in Japan, all adult patients who were (a) hospitalized at our facility from 2010 to 2017, (b) received antibiotic therapy, and (c) for whom an intervention was recommended by our ICT/AST, were eligible for enrolment in this analysis.…”

Section: Introductionmentioning

confidence: 99%

“…Maeda et al [4] showed that an AST intervention approach decreases the use of inappropriate therapy and may improve clinical outcomes in BSI patients and previous other studies have reported that clinical intervention by infectious disease specialists also reduces mortality, length of stay (LOS) and medical costs. These results indicate that ICT/AST interventions can decrease inappropriate therapy and also potentially improve clinical and economic outcomes in severe infectious disease, including pneumonia and BSI by P aeruginosa [9,10].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Microbiological Improvement by Antimicrobial Stewardship Program and Infection Control in Japan

Seki¹,

Watanabe²

2017

J Prev Infect Cntrol

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Microbiological Improvement by Antimicrobial Stewardship Program and Infection Control in Japan

Seki¹,

Watanabe²

2017

J Prev Infect Cntrol

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“…Reducing misuse of antimicrobials by physicians can reduce the proportion of colonized or infected with multidrug-resistant organism [17].Previous study has shown that increasing the allocation of infectious disease physicians can better optimize antimicrobial therapy (11.4%vs. 18.5%; P = 0.012) and may improve clinical outcomes in bloodstream infections patients [29].In fact, previous studies have found a signi cant positive association between physician practice activity and their antimicrobials prescription rates [14,30]. Physicians with high workload may feel it is too time consuming to discuss alternative therapeutic approaches with patients.…”

Section: Discussionmentioning

confidence: 98%

Impact of Medical Professionals on Carbapenem-Resistant Pseudomonas Aeruginosa: Moderating Effect of Workload Based on the Panel Data in China

Han

Zhang

2020

Preprint

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Abstract Background: Antimicrobial resistance (AMR), especially carbapenem-resistant Pseudomonas aeruginosa (CRPA), causes a serious increase in morbidity, mortality and costs. Medical professionals play an important role in curbing AMR. Previous studies overlooked the impact of workload on the relationship between medical professionals and AMR. This study aimed to explore the relationship between medical professionals and the CRPA rate as well as the moderating effect of medical professionals’ workload on this relationship. Methods: A provincial-level panel dataset from 2014 to 2017 was constructed. Medical professionals were measured by the numbers of physicians, registered nurses, pharmacists, and clinical microbiologists per 1000 population. Workload was measured by the number of daily physician visits. Fixed effect model and hierarchical regression analysis were performed to explore the moderating effect of workload on medical professionals and the CRPA rate. Results: The numbers of physicians, registered nurses, pharmacists and clinical technicians were signiﬁcantly negative associated with the CRPA rate (coef. = -0.889, -0.775, -1.176, and -0.822; P= 0.003, 0.003, 0.011, and 0.007, respectively). Workload had a significant and positive moderating effect on physicians, registered nurses, pharmacists, clinical technicians and the CRPA rate (coef.= 1.270, 1.400, 2.210, and 1.634; P=0.004, 0.001, 0.035, and 0.003, respectively). Conclusions: Increasing the number of medical professionals may help curb the CRPA rate. Measures aimed at reducing medical professionals’ workload should be implemented to further improve CRPA performance.

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“…Reducing misuse of antimicrobials by physicians can reduce the proportion of colonized or infected with multidrug-resistant organism [17].Previous study has shown that increasing the allocation of infectious disease physicians can better optimize antimicrobial therapy (11.4%vs. 18.5%; P = 0.012) and may improve clinical outcomes in bloodstream infections patients [27]. In addition, the increased allocation of physicians allow them more time to educate patients on the rational use of antimicrobials, which is conducive to containing of AMR by cooperation of physicians and patients…”

Section: Discussionmentioning

confidence: 99%

Impact of Medical Professionals on Carbapenem-Resistant Pseudomonas Aeruginosa: Moderation Effect of Workload Based on the Panel Data in China

Han

Zhang

2019

Preprint

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Background: Antimicrobial resistance (AMR) causes serious increase in morbidity, mortality and costs, especially carbapenem-resistant Pseudomonas aeruginosa (CRPA). Medical professionals play an important role in tackling AMR. Available studies overlooked the impact of workload on medical professionals in the relationship between medical professionals and AMR. This study explored the relationship between medical professionals and CRPA rate and the moderation effect of medical professionals’ workload in this relationship from a macro perspective. Methods: Based on panel data in China, hierarchical regression analysis was used to explore moderation effect of workload on medical professionals and CRPA rate. Fixed-effect model was applied to estimate the moderation effect models. Medical professionals were measured by the numbers of physicians, registered nurses, pharmacists, clinical microbiologists per 1000 populations. Workload was measured by the number of daily visits of physicians. Results: The numbers of physicians, registered nurses, pharmacists and clinical technicians were signiﬁcant negative with CRPA rate (Coef. = -0.889, -0.775,-1.176, -0.822; P= 0.003, 0.003, 0.011, 0.007, respectively). Workload had significant positive moderation effect between physicians, registered nurses, pharmacists, clinical technicians and CRPA rate (Coef.= 1.270, 1.400, 2.210, 1.634; P=0.004, 0.001, 0.035, 0.003, respectively). Conclusions: Increasing medical professionals may help curb CRPA. Measures to reduce medical professionals’ workload should be implemented to improve CRPA performance further.

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Effect of interventions by an antimicrobial stewardship team on clinical course and economic outcome in patients with bloodstream infection

Cited by 27 publications

References 18 publications

Microbiological Improvement by Antimicrobial Stewardship Program and Infection Control in Japan

Microbiological Improvement by Antimicrobial Stewardship Program and Infection Control in Japan

Impact of Medical Professionals on Carbapenem-Resistant Pseudomonas Aeruginosa: Moderating Effect of Workload Based on the Panel Data in China

Impact of Medical Professionals on Carbapenem-Resistant Pseudomonas Aeruginosa: Moderation Effect of Workload Based on the Panel Data in China

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