Long-term impact of competitive biddings and an antimicrobial stewardship program in a general hospital in Chile

Abstract

Background: The long-term effect of an antimicrobial stewardship program (ASP) and its integrated impact with competitive biddings have been seldom reported. Aim: To evaluate the long-term effect of an ASP on antimicrobial consumption, expenditure, antimicrobial resistance and hospital mortality. To estimate the contribution of competitive biddings on cost-savings. Material and Methods: A comparison of periods prior (2005-2008) and posterior to ASP initiation (2009 and 2015) was done. An estimation of cost savings attributable to ASP and to competitive biddings was also performed. Results: Basal median antimicrobial consumption decreased from 221.3 to 170 daily defined doses/100 beds after the start of the ASP. At the last year, global antimicrobial consumption declined by 28%.

Barriers, facilitators, perceptions and impact of interventions in implementing antimicrobial stewardship programs in hospitals of low-middle and middle countries: a scoping review

“…Most studies (79%, 42/53) primarily documented a decrease in antibiotic consumption and an improvement in rational antibiotic use after ASP implementation in hospitals [ 39 , 46 , 62 , 64 , 66 – 69 , 71 , 73 , 76 – 104 ]. Metrics for evaluating antibiotic consumption included defined daily doses (DDDs) or days of therapy (DOT) per 1,000 patient-days [ 62 – 64 , 68 , 72 , 77 , 79 – 81 , 84 – 86 , 88 , 100 , 104 , 105 ] while some studies used defined daily doses (DDDs) per 100 patient-days or Days of therapy/DOT per 100 patient-days [ 66 , 67 , 76 , 90 , 97 , 102 ].…”

“…Studies also documented a reduction in the incidence of bacterial infections such as Clostridioides difficile infections and Candidemia [ 75 , 77 ], and a decrease in pan-drug resistant isolates [ 65 , 71 , 77 , 85 ]. Economic outcomes were assessed in 17 studies [ 39 , 65 , 69 , 71 , 81 , 86 , 88 – 90 , 93 , 94 , 96 , 100 , 103 , 104 , 107 , 110 ], and reported a decrease in hospital antibiotic procurement cost [ 65 , 71 , 81 , 90 , 93 , 94 ], savings in antibiotic costs [ 39 , 69 , 86 , 88 , 104 , 110 ], decrease in antibiotic therapy and antibiotic prophylaxis cost [ 67 , 107 ], and hospitalization costs [ 110 ].…”

Vigilancia del consumo de antimicrobianos en 10 instituciones de salud entre 2013 y 2020 en Colombia

“…Un programa de vigilancia de consumo de antimicrobianos en un hospital de Santiago de Chile, que incluía una lista de antimicrobianos restringidos, auditorias www.revinf.cl Antimicrobianos con retroalimentación y capacitaciones a los médicos, demostró su efectividad al lograr la reducción del uso de estos medicamentos, así como la reducción del gasto y de la mortalidad por egresos asociados a enfermedades infecciosas 30 .…”

Antimicrobial Stewardship Programs in Latin America and the Caribbean: A Story of Perseverance, Challenges, and Goals

“…For the LAC region, there are different publications analyzing costs and the economic impact of implementing AMS strategies. Most of the publications focus on the impact of reducing antimicrobial consumption on hospital costs [ 24 , 30 , 32 , 39 , 40 ]. According to Fica et al [ 39 ], the long-term effects of ASP and its impact on cost savings are not usually reported.…”

“…Most of the publications focus on the impact of reducing antimicrobial consumption on hospital costs [ 24 , 30 , 32 , 39 , 40 ]. According to Fica et al [ 39 ], the long-term effects of ASP and its impact on cost savings are not usually reported. An observational study comparing two long-term periods in a general hospital in Chile was designed, with a pre-AMS implementation (2005–2008) and post-ASP implementation (2009–2015) evaluation aimed to assess the effect the ASP had on expenditure, consumption, and AMR, as well as to estimate the contribution of competitive biddings on cost savings.…”