Yea-Yuan Chang1, Hsin-Pai Chen2, Chia-Wei Lin3, Jen-Jen Tang3, Ti-Ying Hsu4, Yueh-Chun Weng5, Yuan-Ming Lee5, Wei-Shu Wang6, Su-Shun Lo7. 1. Department of Internal Medicine, National Yang-Ming University Hospital, Yilan, Taiwan, ROC; School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC; Division of Infectious Diseases, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC. 2. Division of Infectious Diseases, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC. 3. Department of Pharmacy, National Yang-Ming University Hospital, Yilan, Taiwan, ROC. 4. Infection Control Office, National Yang-Ming University Hospital, Yilan, Taiwan, ROC. 5. Department of Laboratory Medicine, National Yang-Ming University Hospital, Yilan, Taiwan, ROC. 6. Department of Internal Medicine, National Yang-Ming University Hospital, Yilan, Taiwan, ROC; School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC. Electronic address: 11313@ymuh.ym.edu.tw. 7. School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC; Department of Surgery, National Yang-Ming University Hospital, Yilan, Taiwan, ROC.
Abstract
BACKGROUND: Unnecessary use of antibiotics is a common occurrence in hospitals. Implementation of antibiotic stewardship programs (ASPs) has been shown to reduce both unnecessary antibiotic use and drug-resistant bacteria. Education is a fundamental component of an ASP. However, the effectiveness of proper uses of antibiotics education has not been clearly analyzed. METHODS: In a 520-bed university hospital located in northeastern Taiwan, a significantly increasing prescription of carbapenems, specifically imipenem and meropenem, was observed. An educational program highlighting the judicious use of carbapenems was started, beginning in October 2013. A multidisciplinary ASP was implemented starting in January 2014. The consumption of antibiotics, measured by defined daily dose per 1000 occupied bed-days, was compared among the pre-educational, posteducational, and post-ASP periods. RESULTS: Compared with the pre-educational period, there was a significant reduction in antibiotics consumption of 13% total inpatient antibiotics (p = 0.008), 29.8% carbapenems (p = 0.001), 34.9% imipenem and meropenem (p < 0.001), and 27% glycopeptides (p = 0.015), in the posteducational and post-ASP periods. The major reduction emerged during the posteducational period and was sustained after the ASP. The percentage of inpatients prescribed with antibiotics was significantly decreased (16.2%; p < 0.001). The rate of carbapenem-resistant Acinetobacter baumannii decreased from 70.8% to 29.6% within 7 months. CONCLUSION: A focused educational program is effective in controlling the prescription of specific antibiotic classes in the early phase of a multidisciplinary ASP.
BACKGROUND: Unnecessary use of antibiotics is a common occurrence in hospitals. Implementation of antibiotic stewardship programs (ASPs) has been shown to reduce both unnecessary antibiotic use and drug-resistant bacteria. Education is a fundamental component of an ASP. However, the effectiveness of proper uses of antibiotics education has not been clearly analyzed. METHODS: In a 520-bed university hospital located in northeastern Taiwan, a significantly increasing prescription of carbapenems, specifically imipenem and meropenem, was observed. An educational program highlighting the judicious use of carbapenems was started, beginning in October 2013. A multidisciplinary ASP was implemented starting in January 2014. The consumption of antibiotics, measured by defined daily dose per 1000 occupied bed-days, was compared among the pre-educational, posteducational, and post-ASP periods. RESULTS: Compared with the pre-educational period, there was a significant reduction in antibiotics consumption of 13% total inpatient antibiotics (p = 0.008), 29.8% carbapenems (p = 0.001), 34.9% imipenem and meropenem (p < 0.001), and 27% glycopeptides (p = 0.015), in the posteducational and post-ASP periods. The major reduction emerged during the posteducational period and was sustained after the ASP. The percentage of inpatients prescribed with antibiotics was significantly decreased (16.2%; p < 0.001). The rate of carbapenem-resistant Acinetobacter baumannii decreased from 70.8% to 29.6% within 7 months. CONCLUSION: A focused educational program is effective in controlling the prescription of specific antibiotic classes in the early phase of a multidisciplinary ASP.
Authors: Jorge Alba Fernandez; Jose Luis Del Pozo; Jose Leiva; Mirian Fernandez-Alonso; Irene Aquerreta; Azucena Aldaz; Andres Blanco; Jose Ramón Yuste Journal: Antibiotics (Basel) Date: 2022-03-02