Literature DB >> 33374393

Surgeon-led 7-VINCut Antibiotic Stewardship Intervention Decreases Duration of Treatment and Carbapenem Use in a General Surgery Service.

Josep M Badia1, Maria Batlle1, Montserrat Juvany1, Patricia Ruiz-de León1, Maria Sagalés2, M Angeles Pulido3, Gemma Molist4, Jordi Cuquet5.   

Abstract

Antibiotic stewardship programs optimize the use of antimicrobials to prevent the development of resistance and improve patient outcomes. In this prospective interventional study, a multidisciplinary team led by surgeons implemented a program aimed at shortening the duration of antibiotic treatment <7 days. The impact of the intervention on antibiotic consumption adjusted to bed-days and discharges, and the isolation of multiresistant bacteria (MRB) was also studied. Furthermore, the surgeons were surveyed regarding their beliefs and feelings about the program. Out of 1409 patients, 40.7% received antibiotic therapy. Treatment continued for over 7 days in 21.5% of cases, and, as can be expected, source control was achieved in only 48.8% of these cases. The recommendations were followed in 90.2% of cases, the most frequent being to withdraw the treatment (55.6%). During the first 16 months of the intervention, a sharp decrease in the percentage of extended treatments, with R2 = 0.111 was observed. The program was very well accepted by surgeons, and achieved a decrease in both the consumption of carbapenems and in the number of MRB isolations. Multidisciplinary stewardship teams led by surgeons seem to be well received and able to better manage antibiotic prescription in surgery.

Entities:  

Keywords:  anti-bacterial agents/therapeutic use*; antimicrobial stewardship/organization and administration*; antimicrobial stewardship/statistics and numerical data*; bacterial/drug effects; drug resistance; general surgery/standards*; infection control/organization and administration; multiple; surgical wound infection/prevention and control

Year:  2020        PMID: 33374393      PMCID: PMC7823351          DOI: 10.3390/antibiotics10010011

Source DB:  PubMed          Journal:  Antibiotics (Basel)        ISSN: 2079-6382


  48 in total

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Authors:  Jeremy M Grimshaw; Martin P Eccles; Anne E Walker; Ruth E Thomas
Journal:  J Contin Educ Health Prof       Date:  2002       Impact factor: 1.355

2.  [Measurement of antimicrobial consumption using DDD per 100 bed-days versus DDD per 100 discharges after the implementation of an antimicrobial stewardship program].

Authors:  Roberto Collado; Juan Emilio Losa; Elena Alba Álvaro; Piedad Toro; Leonor Moreno; Montserrat Pérez
Journal:  Rev Esp Quimioter       Date:  2015-12       Impact factor: 1.553

3.  The Surgical Infection Society Revised Guidelines on the Management of Intra-Abdominal Infection.

Authors:  John E Mazuski; Jeffrey M Tessier; Addison K May; Robert G Sawyer; Evan P Nadler; Matthew R Rosengart; Phillip K Chang; Patrick J O'Neill; Kevin P Mollen; Jared M Huston; Jose J Diaz; Jose M Prince
Journal:  Surg Infect (Larchmt)       Date:  2017-01       Impact factor: 2.150

4.  Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America guidelines for developing an institutional program to enhance antimicrobial stewardship.

Authors:  Timothy H Dellit; Robert C Owens; John E McGowan; Dale N Gerding; Robert A Weinstein; John P Burke; W Charles Huskins; David L Paterson; Neil O Fishman; Christopher F Carpenter; P J Brennan; Marianne Billeter; Thomas M Hooton
Journal:  Clin Infect Dis       Date:  2006-12-13       Impact factor: 9.079

Review 5.  Antimicrobial stewardship programs in inpatient hospital settings: a systematic review.

Authors:  Brittin Wagner; Gregory A Filice; Dimitri Drekonja; Nancy Greer; Roderick MacDonald; Indulis Rutks; Mary Butler; Timothy J Wilt
Journal:  Infect Control Hosp Epidemiol       Date:  2014-08-21       Impact factor: 3.254

6.  Evaluation of a Short Course of Antimicrobial Therapy for Complicated Intra-Abdominal Infections in Critically Ill Surgical Patients.

Authors:  Susan E Smith; Kelli A Rumbaugh; Addison K May
Journal:  Surg Infect (Larchmt)       Date:  2017 Aug/Sep       Impact factor: 2.150

7.  Longer-Duration Antimicrobial Therapy Does Not Prevent Treatment Failure in High-Risk Patients with Complicated Intra-Abdominal Infections.

Authors:  Taryn E Hassinger; Christopher A Guidry; Ori D Rotstein; Therese M Duane; Heather L Evans; Charles H Cook; Patrick J O'Neill; John E Mazuski; Reza Askari; Lena M Napolitano; Nicholas Namias; Preston R Miller; E Patchen Dellinger; Raul Coimbra; Christine S Cocanour; Kaysie L Banton; Joseph Cuschieri; Kimberley Popovsky; Robert G Sawyer
Journal:  Surg Infect (Larchmt)       Date:  2017-06-26       Impact factor: 2.150

8.  Association of excessive duration of antibiotic therapy for intra-abdominal infection with subsequent extra-abdominal infection and death: a study of 2,552 consecutive infections.

Authors:  Lin M Riccio; Kimberley A Popovsky; Tjasa Hranjec; Amani D Politano; Laura H Rosenberger; Kristin C Tura; Robert G Sawyer
Journal:  Surg Infect (Larchmt)       Date:  2014-05-13       Impact factor: 2.150

9.  Emergency surgeons' perceptions and attitudes towards antibiotic prescribing and resistance: a worldwide cross-sectional survey.

Authors:  Francesco M Labricciosa; Massimo Sartelli; Sofia Correia; Lilian M Abbo; Milton Severo; Luca Ansaloni; Federico Coccolini; Carlos Alves; Renato Bessa Melo; Gian Luca Baiocchi; José-Artur Paiva; Fausto Catena; Ana Azevedo
Journal:  World J Emerg Surg       Date:  2018-06-28       Impact factor: 5.469

10.  Increase in Pediatric Perforated Appendicitis in the New York City Metropolitan Region at the Epicenter of the COVID-19 Outbreak.

Authors:  Jason C Fisher; Sandra S Tomita; Howard B Ginsburg; Alex Gordon; David Walker; Keith A Kuenzler
Journal:  Ann Surg       Date:  2021-03-01       Impact factor: 13.787

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