Long-term efficacy of comprehensive multidisciplinary antibiotic stewardship programs centered on weekly prospective audit and feedback

Kondo, Takahisa; Uda, Atsushi; Sakaue, Tomoyuki; Yamashita, K.; Nishioka, Tatsuya; Nishimura, Shigeo; Ebisawa, Kei; Nagata, Manabu; Ohji, Goh; Nakamura, Tatsuya; Koike, Chihiro; Kusuki, Mari; Ioroi, Takeshi; Mukai, Akira; Abe, Yasuhisa; Yoshida, Hiroyuki; Hirai, Midori; Arakawa, Soichi; Yano, Ikuko; Iwata, Kentaro; Tokimatsu, Issei

doi:10.1007/s15010-017-1099-8

Cited by 31 publications

(24 citation statements)

References 41 publications

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“…Honda et al reported that the initiation of adequate empiric antimicrobial therapy had important implications for AS even in the elderly population in Japan [9]. Other studies have also discussed AST and infectious disease control from the point of view of physicians, pharmacists, or clinical microbiologists [6,[10][11][12].…”

Section: Discussionmentioning

confidence: 99%

“…Our study was conducted with a well-established AST over five years [6]. Statistical analyses showed that the percentage of cases of inappropriate broad-spectrum antibiotic use and interventions for indefinite infections had significantly decreased, whereas the number of blood or drainage culture submissions had significantly increased over the five-year study period.…”

Section: Discussionmentioning

confidence: 99%

“…In these AST meetings, pharmacists, clinical microbiologists, nurses, and infectious disease physicians, including a urologist, collaborated to optimize the use of broad-spectrum antimicrobial agents for each patient. We found that this project was highly effective in reducing the use of antipseudomonal antibiotics [6].…”

Section: Antimicrobial Stewardship Team (Ast) Meetingsmentioning

confidence: 92%

“…In March 2010, Kobe University Hospital started AST meetings which was called as the "Big Gun Project" in our hospital and focused on weekly prospective audit and feedback [6]. The main objectives of this project team were to promote the appropriate use of antimicrobial agents and to prevent the emergence of AMR.…”

Section: Antimicrobial Stewardship Team (Ast) Meetingsmentioning

confidence: 99%

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How Does Antimicrobial Stewardship Affect Inappropriate Antibiotic Therapy in Urological Patients?

et al. 2020

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Antimicrobial stewardship teams (ASTs) have been well-accepted in recent years; however, their clinical outcomes have not been fully investigated in urological patients. The purpose of this study was to evaluate the outcomes of intervention via a retrospective review of urological patients, as discussed in the AST meetings, who were treated with broad-spectrum antibiotics between 2014 and 2018 at the Department of Urology, Kobe University Hospital in Japan. Interventions were discussed in AST meetings for patients identified by pharmacists as having received inappropriate antibiotic therapy. The annual changes in numbers of inappropriate medications and culture submissions over five years at the urology department were statistically analyzed. Among 1,033 patients audited by pharmacists, inappropriate antibiotic therapy was found in 118 cases (11.4%). The numbers of inappropriate antibiotic use cases and of interventions for indefinite infections had significantly decreased during the study period (p = 0.012 and p = 0.033, respectively). However, the number of blood and drainage culture submissions had significantly increased (p = 0.009 and p = 0.035, respectively). Our findings suggest that urologists have probably become more familiar with infectious disease management through AST intervention, leading to a decrease in inappropriate antibiotic use and an increase in culture submissions.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Antimicrobial Stewardship Team (Ast) Meetingsmentioning

confidence: 92%

Section: Antimicrobial Stewardship Team (Ast) Meetingsmentioning

confidence: 99%

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How Does Antimicrobial Stewardship Affect Inappropriate Antibiotic Therapy in Urological Patients?

et al. 2020

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“…A study conducted by Kimura [17], which evaluated the long-term effects of antibiotic administration programs at a university hospital in Japan, found that therapy days per 1000 patient-days were higher for 1st generation cephalosporins (45 DOT / 1000pd). The time of use of quinolones (4.7 DOT / 1000pd) and carbapenems (13.5 DOT / 1000pd) were well below the values veri ed in this study.…”

Section: Discussionmentioning

confidence: 99%

Use of Monitoring Indicators in Hospital Management of Antimicrobials

Silva

Mendonça

Leão

et al. 2020

Preprint

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Background: It is described in the literature that between 25% to 50% of antimicrobial prescriptions, in the hospital environment, are unnecessary or inadequate, directly impacting antimicrobial resistance. The National Health Surveillance Agency launched the “Brazil Stewardship Project” to assess the national panorama of antimicrobial use management programs, therefore, it is expected that managers will be encouraged to implement the antimicrobial use management program, with the publication of the results, enabling the comparison of national data. In this context, measures and indicators of antimicrobial use will be particularly important. We demonstrate the application of the indicators DOT, LOT e DOT/LOT ratio to explore and monitor antimicrobials use. Methods: This is an observational, analytical and prospective study conducted in a teaching hospital, with 94 active beds, distributed between the intensive care unit (ICU), the surgical clinic (SUR), the medical clinic (MED), the pneumology/infectology (PNE/INF) and pediatrics (PED). Results: During the study period, a total of 11,634 patient-days were followed up and an average of 50.4% of patients were exposed to some antimicrobial, showing significant reduction throughout the year. In 376 days, for every 1,000 days of hospitalization, patients were receiving antimicrobial therapy (LOT = 376/1000pd). Overall, the 1st generation cephalosporins and fluoroquinolones were highlighted both in the number of prescriptions and in the duration of therapy. The calculated global DOT / LOT ratio showed that each patient received an average of 1.5 antimicrobials during the hospital stay. The incidence of antimicrobial resistance, globally, for both Methicillin R and Carbapenem R , was 1 per 1000 patient-days. Conclusions: The indicators addressed in this study proved to be of great relevance for obtaining data regarding the use of antimicrobials, contributing to the initiatives to be taken by the Stewardship program. This study is expected to encourage other hospitals to monitor the use of antimicrobials, allowing comparison of data.

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Antibiotic Stewardship

Baird¹

2018

Neonatal Infections

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Long-term efficacy of comprehensive multidisciplinary antibiotic stewardship programs centered on weekly prospective audit and feedback

Abstract: The comprehensive ASPs had long-term efficacy for reducing the use of the targeted broad-spectrum antibiotics, maintaining the antibiotic susceptibility of P. aeruginosa, and decreasing the prevalence of MRSA, without adversely affecting clinical outcome.

Cited by 31 publications

References 41 publications

How Does Antimicrobial Stewardship Affect Inappropriate Antibiotic Therapy in Urological Patients?

How Does Antimicrobial Stewardship Affect Inappropriate Antibiotic Therapy in Urological Patients?

Use of Monitoring Indicators in Hospital Management of Antimicrobials

Antibiotic Stewardship

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