J Ruiz1, P Ramirez2, M Gordon1, E Villarreal1, J Frasquet3, J L Poveda-Andres4, M Salavert-Lletí5, A Catellanos1. 1. Intensive Care Unit, Hospital Universitario y Politecnico La Fe, Valencia, Spain. 2. Intensive Care Unit, Hospital Universitario y Politecnico La Fe, Valencia, Spain. Electronic address: ramirez_pau@gva.es. 3. Microbiology Department, Hospital Universitario y Politecnico La Fe, Valencia, Spain. 4. Pharmacy Department, Hospital Universitario y Politecnico La Fe, Valencia, Spain. 5. Infectious Disease Department, Hospital Universitario y Politecnico La Fe, Valencia, Spain.
Abstract
OBJECTIVE: Hospital antimicrobial stewardship programmes have achieved savings and a more rational use of antimicrobial treatments in general wards. The purpose of this report is to evaluate the experience of an antimicrobial stewardship programme in an intensive care unit (ICU). DESIGN: Prospective interventional, before-and-after study. SCOPE: 24-bed medical ICU in a tertiary hospital. INTERVENTION: Prospective audit and feedback antimicrobial stewardship programme. ENDPOINTS: Antimicrobial consumption, antimicrobial related costs, multi-drug resistant microorganisms (MDRM) prevalence, nosocomial infections incidence, ICU length of stay, and ICU mortality rates were compared before and after one-year intervention. RESULTS: A total of 218 antimicrobial episodes of 182 patients were evaluated in 61 team meetings. Antimicrobial stewardship suggestions were accepted in 91.5% of the cases. Total antimicrobial DDD/100 patient-days consumption was reduced from 380.6 to 295.2 (-22.4%; p=0.037). Antimicrobial stewardship programme was associated with a significant decrease in the prescription of penicillins plus b-lactamase inhibitors, linezolid, cephalosporins, and aminoglycosides. Overall antimicrobial spending was reduced by €119,636. MDRM isolation and nosocomial infections per 100 patient-days did not change after the intervention period. No changes in length of stay or mortality rate were observed. CONCLUSIONS: An ICU antimicrobial stewardship programme significantly reduced antimicrobial use without affecting inpatient mortality and length of stay. Our results further support the implementation of an antimicrobial stewardship programme in critical care units.
OBJECTIVE: Hospital antimicrobial stewardship programmes have achieved savings and a more rational use of antimicrobial treatments in general wards. The purpose of this report is to evaluate the experience of an antimicrobial stewardship programme in an intensive care unit (ICU). DESIGN: Prospective interventional, before-and-after study. SCOPE: 24-bed medical ICU in a tertiary hospital. INTERVENTION: Prospective audit and feedback antimicrobial stewardship programme. ENDPOINTS: Antimicrobial consumption, antimicrobial related costs, multi-drug resistant microorganisms (MDRM) prevalence, nosocomial infections incidence, ICU length of stay, and ICU mortality rates were compared before and after one-year intervention. RESULTS: A total of 218 antimicrobial episodes of 182 patients were evaluated in 61 team meetings. Antimicrobial stewardship suggestions were accepted in 91.5% of the cases. Total antimicrobial DDD/100 patient-days consumption was reduced from 380.6 to 295.2 (-22.4%; p=0.037). Antimicrobial stewardship programme was associated with a significant decrease in the prescription of penicillins plus b-lactamase inhibitors, linezolid, cephalosporins, and aminoglycosides. Overall antimicrobial spending was reduced by €119,636. MDRM isolation and nosocomial infections per 100 patient-days did not change after the intervention period. No changes in length of stay or mortality rate were observed. CONCLUSIONS: An ICU antimicrobial stewardship programme significantly reduced antimicrobial use without affecting inpatient mortality and length of stay. Our results further support the implementation of an antimicrobial stewardship programme in critical care units.
Authors: Elena Fresán-Ruiz; Ana Carolina Izurieta-Pacheco; Mònica Girona-Alarcón; Juan Carlos de Carlos-Vicente; Amaya Bustinza-Arriortua; María Slocker-Barrio; Sylvia Belda-Hofheinz; Montserrat Nieto-Moro; Sonia María Uriona-Tuma; Laia Pinós-Tella; Elvira Morteruel-Arizcuren; Cristina Schuffelmann; Yolanda Peña-López; Sara Bobillo-Pérez; Iolanda Jordan Journal: Children (Basel) Date: 2022-06-16
Authors: Alexis Tabah; Matteo Bassetti; Marin H Kollef; Jean-Ralph Zahar; José-Artur Paiva; Jean-Francois Timsit; Jason A Roberts; Jeroen Schouten; Helen Giamarellou; Jordi Rello; Jan De Waele; Andrew F Shorr; Marc Leone; Garyphallia Poulakou; Pieter Depuydt; Jose Garnacho-Montero Journal: Intensive Care Med Date: 2019-11-28 Impact factor: 17.440
Authors: Liesbet De Bus; Pieter Depuydt; Johan Steen; Sofie Dhaese; Ken De Smet; Alexis Tabah; Murat Akova; Menino Osbert Cotta; Gennaro De Pascale; George Dimopoulos; Shigeki Fujitani; Jose Garnacho-Montero; Marc Leone; Jeffrey Lipman; Marlies Ostermann; José-Artur Paiva; Jeroen Schouten; Fredrik Sjövall; Jean-François Timsit; Jason A Roberts; Jean-Ralph Zahar; Farid Zand; Kapil Zirpe; Jan J De Waele Journal: Intensive Care Med Date: 2020-06-09 Impact factor: 17.440
Authors: P Ramírez; M Gordón; M Martín-Cerezuela; E Villarreal; E Sancho; M Padrós; J Frasquet; G Leyva; I Molina; M Barrios; S Gimeno; Á Castellanos Journal: Med Intensiva (Engl Ed) Date: 2020-07-11