Jaffar A Al-Tawfiq1, Hisham Momattin2, Fatemah Al-Habboubi3, Stephanie J Dancer4. 1. Specialty Internal Medicine, Saudi Aramco Medical Services Organization, Dhahran, Saudi Arabia; Indiana University School of Medicine, IN, USA. Electronic address: jaffar.tawfiq@aramco.com. 2. Pharmacy Services Division, Saudi Aramco Medical Services Organization, Dhahran, Saudi Arabia. 3. Microbiology Lab, Saudi Aramco Medical Services Organization, Dhahran, Saudi Arabia. 4. Department of Microbiology, Hairmyres Hospital, NHS Lanarkshire, UK.
Abstract
BACKGROUND: Cascade and restrictive reporting are useful strategies to enhance antibiotic stewardship programs. METHODS: We combined both strategies to improve the prescribing of antibiotics aimed at Gram-negative infections. RESULTS: For Enterobacter aerogenes, the susceptibility rates to amikacin increased from 10% to 100%; for third generation cephalosporins, these rates increased from 55% to 89%. The susceptibility rates of E. aerogenes to cefepime and piperacillin-tazobactam changed little, and the ampicillin susceptibility decreased from 30% in 2009 to 11% in 2010. For Proteus mirabilis, the susceptibility rates increased for third-generation cephalosporins (48% vs. 92%) and piperacillin-tazobactam (10% vs. 98%), with minimal changes for cefepime (96% vs. 93%), ampicillin (69% vs. 73%) and amikacin (96% vs. 84%). For Pseudomonas aeruginosa, the susceptibility rates improved slightly for third-generation cephalosporins (81% vs. 91%) but reduced for piperacillin-tazobactam (99% vs. 59%). Hospital-acquired Clostridium difficile infections decreased from 0.11 to 0.07 per 1000 patient days. CONCLUSIONS: Selective reporting helps physicians choose the most appropriate antibiotics for their patients within a stewardship program, with reduced C. difficile infection.
BACKGROUND: Cascade and restrictive reporting are useful strategies to enhance antibiotic stewardship programs. METHODS: We combined both strategies to improve the prescribing of antibiotics aimed at Gram-negative infections. RESULTS: For Enterobacter aerogenes, the susceptibility rates to amikacin increased from 10% to 100%; for third generation cephalosporins, these rates increased from 55% to 89%. The susceptibility rates of E. aerogenes to cefepime and piperacillin-tazobactam changed little, and the ampicillin susceptibility decreased from 30% in 2009 to 11% in 2010. For Proteus mirabilis, the susceptibility rates increased for third-generation cephalosporins (48% vs. 92%) and piperacillin-tazobactam (10% vs. 98%), with minimal changes for cefepime (96% vs. 93%), ampicillin (69% vs. 73%) and amikacin (96% vs. 84%). For Pseudomonas aeruginosa, the susceptibility rates improved slightly for third-generation cephalosporins (81% vs. 91%) but reduced for piperacillin-tazobactam (99% vs. 59%). Hospital-acquired Clostridium difficile infections decreased from 0.11 to 0.07 per 1000 patient days. CONCLUSIONS: Selective reporting helps physicians choose the most appropriate antibiotics for their patients within a stewardship program, with reduced C. difficileinfection.
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Authors: Awad Al-Omari; Abbas Al Mutair; Saad Alhumaid; Samer Salih; Ahmed Alanazi; Hesham Albarsan; Maha Abourayan; Maha Al Subaie Journal: Antimicrob Resist Infect Control Date: 2020-06-29 Impact factor: 4.887
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