Evaluation of effects of an operational multidisciplinary team on antibiotic use in the medium to long term at a French university hospital

Abstract

Background Antibiotic-resistant bacteria are a major public health problem throughout the world. In 2006, in accordance with the national guidelines for antibiotic use, the CHRU of Nancy created an operational multidisciplinary antibiotic team at one of its sites. In 2011, a cluster-controlled trial showed that the operational multidisciplinary antibiotic team (the intervention) had a favourable short-term effect on antibiotic use and costs. Objective Our objective was to determine whether these effects continued over the medium to long term (that is, 2-7 years after creation of the operational multidisciplinary antibiotic team, 2009-2014). Setting The 1800-bed University Hospital of Nancy (France). Method The effect in the medium to long term is measured according to the same criteria and assessed by the same methods as the first study. A cluster controlled trial was performed on the period 2009-2014. The intervention group comprised 11 medical and surgical wards in settings where the operational multidisciplinary antibiotic team was implemented and the control group comprised 6 wards without this operational team. Main outcome measure Consumption of antibiotics overall and by therapeutic class (in defined daily doses per 1000 patient-days) and costs savings (in €). Results The reduction in antibiotic use and costs continued, but at a lower rate than in the short term (11% between 2009 and 2014 compared with 33% between 2007 and 2009) at the site of the intervention. The principal decreases concerned fluoroquinolones and glycopeptides. At the site without an operational multidisciplinary antibiotic team (the control group), total antibiotic use remained stable. Between 2009 and 2014, costs fell 10.5% in the intervention group and 5.7% in the control group. Conclusion This study shows that it is possible to maintain the effectiveness over time of such an intervention and demonstrates its role in defining a hospital's antibiotic policy.

Assessment of antibiotic prescriptions in pediatric care units in a regional university hospital

“…It could also be interesting to set up an operational team made of an infectious disease specialist and a pharmacist, which would be dedicated to pediatric wards. This team could analyze last resort antibiotic prescriptions upon initiation, and a systematic reevaluation could be performed at least once a week similarly to what is being implemented since 2006 for adults at the University Hospital of Nancy [1,2]. Findings from the present study were presented to the Neonatology Pole to set up an action plan.…”

“…Our regional university hospital set up an operational team made of an infectious disease specialist and a pharmacist in 2006 [1,2]. The team promotes the proper use of antibiotics and contributed to reducing antibiotic consumption in the hospital.…”

Evaluating antibiotic stewardship and healthcare-associated infections surveillance assisted by computer: protocol for an interrupted time series study

“…The AMS team aims at reducing inappropriate and unnecessary antibiotic prescribing. The AMS programme in the University Hospital of Nancy was described in 2011 by Bevilacqua et al 27 and evaluated in two studies 28 29. Currently, the AMS team reviews antibiotic prescriptions without a specific software: hospital pharmacists analyse all electronic antibiotic prescriptions one by one using the electronic patient’s medical record.…”

Policies to Reduce Antibiotic Consumption: The Impact in the Basque Country

“…All of them conclude with the recommendation not only to introduce health policies to reduce the consumption of these drugs but also to quantify the results. Currently, it is known that introducing these policies significantly reduces the consumption of antibiotics within one year, in both hospital settings [ 20 , 21 ] and primary care [ 22 ].…”