Massimo Sartelli1, Francesco Maria Labricciosa2, Loredana Scoccia3, Jessica Bellesi4, Maria Rita Mazzoccanti5, Giorgia Scaloni5, Bianca Gentilozzi5, Alessandro Chiodera6. 1. 1 Department of Surgery, Macerata Hospital , Macerata, Italy . 2. 2 Department of Biomedical Sciences and Public Health, Unit of Hygiene, Preventive Medicine and Public Health , UNIVPM, Ancona, Italy . 3. 3 Unit of Hospital Pharmacy, Macerata Hospital , Macerata, Italy . 4. 4 Unit of Laboratory Medicine, Macerata Hospital , Macerata, Italy . 5. 5 Clinical Administration, Macerata Hospital , Macerata, Italy . 6. 6 Unit of Infectious Diseases, Macerata Hospital , Macerata, Italy .
Abstract
BACKGROUND: The goal of an antimicrobial stewardship program (ASP) is to prevent the emergence of antimicrobial drug resistance and reduce adverse drug events, optimizing the selection, dosing, and duration of therapy in individual patients. METHODS: This retrospective study evaluated changes in antimicrobial agent use associated with implementation of an ASP in a general and emergency unit. The pre-intervention and post-intervention periods were defined as July 1, 2013, to December 31, 2013 (pre-intervention) and January 1, 2014, to June 30, 2014 (post-intervention). RESULTS: The mean total monthly antimicrobial use decreased by 18.8%, from 1,074.9 defined daily doses (DDD) per 1,000 patient-days to 873.0 DDD per 1,000 patient-days after the intervention. There was a significant reduction in the use of piperacillin-tazobactam, by 33.7% (p < 0.05), in imipenem/cilastatin, by 63.9% (p < 0.05), in meropenem by 68.0% (p < 0.05), and in levofloxacin by 45.0% (p < 0.05) without any negative effect on patient susceptibility to infections. Indeed, patient outcomes, including deaths, length of stay in the hospital, and re-admission within 30 days were not affected. CONCLUSIONS: The implementation of an education-based ASP achieved a significant improvement in all antimicrobial agent prescriptions in the surgical unit and a reduction in antimicrobial drug consumption, even when no restrictive measures were implemented.
BACKGROUND: The goal of an antimicrobial stewardship program (ASP) is to prevent the emergence of antimicrobial drug resistance and reduce adverse drug events, optimizing the selection, dosing, and duration of therapy in individual patients. METHODS: This retrospective study evaluated changes in antimicrobial agent use associated with implementation of an ASP in a general and emergency unit. The pre-intervention and post-intervention periods were defined as July 1, 2013, to December 31, 2013 (pre-intervention) and January 1, 2014, to June 30, 2014 (post-intervention). RESULTS: The mean total monthly antimicrobial use decreased by 18.8%, from 1,074.9 defined daily doses (DDD) per 1,000 patient-days to 873.0 DDD per 1,000 patient-days after the intervention. There was a significant reduction in the use of piperacillin-tazobactam, by 33.7% (p < 0.05), in imipenem/cilastatin, by 63.9% (p < 0.05), in meropenem by 68.0% (p < 0.05), and in levofloxacin by 45.0% (p < 0.05) without any negative effect on patient susceptibility to infections. Indeed, patient outcomes, including deaths, length of stay in the hospital, and re-admission within 30 days were not affected. CONCLUSIONS: The implementation of an education-based ASP achieved a significant improvement in all antimicrobial agent prescriptions in the surgical unit and a reduction in antimicrobial drug consumption, even when no restrictive measures were implemented.
Authors: Massimo Sartelli; Therese M Duane; Fausto Catena; Jeffrey M Tessier; Federico Coccolini; Lillian S Kao; Belinda De Simone; Francesco M Labricciosa; Addison K May; Luca Ansaloni; John E Mazuski Journal: Surg Infect (Larchmt) Date: 2016-11-09 Impact factor: 2.150
Authors: Jun Rong Jeffrey Neo; Jeff Niederdeppe; Ole Vielemeyer; Brandyn Lau; Michelle Demetres; Hessam Sadatsafavi Journal: J Med Syst Date: 2020-02-10 Impact factor: 4.460
Authors: Massimo Sartelli; Yoram Kluger; Luca Ansaloni; Federico Coccolini; Gian Luca Baiocchi; Timothy C Hardcastle; Ernest E Moore; Addison K May; Kamal M F Itani; Donald E Fry; Marja A Boermeester; Xavier Guirao; Lena Napolitano; Robert G Sawyer; Kemal Rasa; Fikri M Abu-Zidan; Abdulrashid K Adesunkanmi; Boyko Atanasov; Goran Augustin; Miklosh Bala; Miguel A Cainzos; Alain Chichom-Mefire; Francesco Cortese; Dimitris Damaskos; Samir Delibegovic; Zaza Demetrashvili; Belinda De Simone; Therese M Duane; Wagih Ghnnam; George Gkiokas; Carlos A Gomes; Andreas Hecker; Aleksandar Karamarkovic; Jakub Kenig; Vladimir Khokha; Victor Kong; Arda Isik; Ari Leppäniemi; Andrey Litvin; Eftychios Lostoridis; Gustavo M Machain; Sanjay Marwah; Michael McFarlane; Cristian Mesina; Ionut Negoi; Iyiade Olaoye; Tadeja Pintar; Guntars Pupelis; Miran Rems; Ines Rubio-Perez; Boris Sakakushev; Helmut Segovia-Lohse; Boonying Siribumrungwong; Peep Talving; Jan Ulrych; András G Vereczkei; Francesco M Labricciosa; Fausto Catena Journal: World J Emerg Surg Date: 2018-08-17 Impact factor: 5.469