Impact of antimicrobial stewardship interventions on Clostridium difficile infection and clinical outcomes: segmented regression analyses

Patton, Andrea; Davey, Peter; Harbarth, Stéphan Juergen; Nathwani, Dilip; Sneddon, Jacqueline; Marwick, Charis

doi:10.1093/jac/dkx413

Cited by 21 publications

(11 citation statements)

References 23 publications

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“…A patient was diagnosed with CDI when he or she had diarrhea (three or more unformed stool movements within 24 h) and tested positive in an approach included an ELISA A + B kits (Abnova, Catalog Number KA3202) [13].…”

Section: Case Definitionmentioning

confidence: 99%

Impact of an antimicrobial stewardship program in the antimicrobial-resistant and prevalence of clostridioides difficile infection and amount of antimicrobial consumed in cancer patients

2020

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Objective The The impact of a hospital antimicrobial stewardship was determined on antimicrobial-resistant, Clostridioides difficile rates and the amount of antimicrobial consumed in cancer patients.The intervention effects of antimicrobial stewardship (ASP) plans in 2017–2018 and 2018–2019 were respectively evaluated among hematology/oncology and bone marrow transplant patients in Ayatollah Taleghani University Hospital, Tehran, Iran. In this interventional quasi-experimental study, the ASP repository was utilized to capture four survey questions encompassed in these immunocompromised patients: amount of antibiotics (meropenem and vancomycin) consumption gr-year, the number of positive Clostridioides difficile infection and multidrug-resistant positive cases in blood cultures. Results The number of MDR cases in the periods of 2017–2018 and 2018–2019 were 145 and 75, respectively (p = 0.011). A significant reduction in all positive blood cultures from 2017–2018 to 2018–2019 was found (p = 0.001). 574 patients admitted to our hospital in these periods of 2017- 2018 and 2018- 2019were assessed for MPM and VMN use. The amounts of MPM prescriptions in 2018–2019 was significantly decreased from 22464 to 17262 g (p = 0.043). The significant reduction in antibiotic consumption, MDR organisms, and CDI can highly promote patients’ health and decreasing medical costs and long-term defects for patients.

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Section: Case Definitionmentioning

confidence: 99%

Impact of an antimicrobial stewardship program in the antimicrobial-resistant and prevalence of clostridioides difficile infection and amount of antimicrobial consumed in cancer patients

2020

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“…As mentioned in the study design section, the confounding influence of concurrent infection prevention initiatives is often overlooked. AMS clinicians should consider including a discussion of infection prevention practices and/or some measure of infection prevention practice intensity over time . Again, supplementary data or an appendix could be utilized to include these details.…”

Section: Designing Ams Studies For Scholarshipmentioning

confidence: 99%

Designing antimicrobial stewardship initiatives to enhance scientific dissemination

Pagels

McCreary

Rose

et al. 2019

J Am Coll Clin Pharm

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Antimicrobial overuse and resistance pose an immediate threat to human health. Antimicrobial stewardship (AMS) refers to efforts designed to improve antimicrobial use and optimize associated outcomes across health care settings. Pharmacists are integral leaders of AMS teams and are increasingly engaged in AMS research. However, AMS scholarship often lacks scientific rigor and subsequently, representative evidence in AMS guidelines is low quality. Because pharmacists are often on the front lines of AMS in health care systems, they must be cognizant of robust AMS study design to increase both quality and generalizability of their AMS interventions and observations. Sustainability of AMS interventions is equally important. This paper provides a primer for pharmacists engaged in AMS on fundamental AMS scholarship concepts including defining the study objective, study design, study methodology, data analysis, and promoting sustainability of the intervention. Recommendations are made for pharmacists across the spectrum of AMS, from new to well‐established programs. Additional AMS training and AMS scholarship is needed to support both the profession and pharmacists engaged in AMS. A concerted effort by pharmacists to enhance the quality of AMS research may improve AMS scholarship impact and further enhance outcomes throughout the continuum of care.

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“…A patient was diagnosed with CDI when he or she had diarrhea (three or more unformed stool movements within 24 h) and tested positive in an approach included an ELISA A+B kits (Abnova, Catalog Number KA3202) (12).…”

Section: Case Definitionmentioning

confidence: 99%

Impact of an antimicrobial stewardship program in the antimicrobial-resistant and prevalence of clostridium difficile infection and amount of antimicrobial consumed in cancer patients

Mardani

Abolghasemi

Shabani

2019

Preprint

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Objective: The objective of this study was to determine the impact of a hospital antimicrobial stewardship on antimicrobial resistant, clostridium difficile rates and amount of antimicrobial consumed in cancer patients. The intervention effects of ASP plans in 2017-2018 and 2018-2019 were respectively evaluated among hematology/oncology and bone morrow transplant patients in Ayatollah Taleghani University Hospital, Tehran, Iran. In this interventional quasi-experimental study, the ASP repository was utilized to capture four survey questions encompassed in these immunocompromised patients: amount of antibiotics (MPM and VMN) consumption gr-year, number of positive clostridium difficile infection and multidrug resistant positive cases in blood cultures.Results: The number of MDR cases in the time periods of 2017-2018 and 2018-2019 were 145 and 75, respectively (p = 0.011). A significant reduction in positive blood cultures from 2017-2018 to 2018-2019 was found (p = 0.001).The amount of MPM prescriptions in 2018-2019 was significantly decreased from 22464 to 17262 g (p = 0.043). The significant reduction in antibiotic consumption, MDR organisms and CDI can highly promote patients' health and decreasing medical costs and longterm defects for patients. Finally, future stewardship studies should made efforts for joining clinical and epidemiological studies.

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Impact of antimicrobial stewardship interventions on Clostridium difficile infection and clinical outcomes: segmented regression analyses

Abstract: Despite large reductions in HRA prescribing and reductions in CDI, demonstrating real-world impact of stewardship interventions remains challenging.

Cited by 21 publications

References 23 publications

Impact of an antimicrobial stewardship program in the antimicrobial-resistant and prevalence of clostridioides difficile infection and amount of antimicrobial consumed in cancer patients

Impact of an antimicrobial stewardship program in the antimicrobial-resistant and prevalence of clostridioides difficile infection and amount of antimicrobial consumed in cancer patients

Designing antimicrobial stewardship initiatives to enhance scientific dissemination

Impact of an antimicrobial stewardship program in the antimicrobial-resistant and prevalence of clostridium difficile infection and amount of antimicrobial consumed in cancer patients

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