Wooyoung Jang1, Hyeonjun Hwang2, Hyun-Uk Jo3, Yong-Han Cha4, Bongyoung Kim5. 1. School of Medicine, Hanyang University College of Medicine, Seoul, South Korea. 2. Center for Service Industry, Korea Institute for Industrial Economics and Trade, Sejong, South Korea. 3. Department of Urology, Eulji University College of Medicine, Daejeon, South Korea; Department of Urology, Good Munhwa Hospital, Busan, South Korea. 4. Department of Orthopaedics, Eulji University Hospital, Daejeon, South Korea. 5. Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea. Electronic address: sobakas@hanyang.ac.kr.
Abstract
OBJECTIVES: This study aimed to analyse the effect of discontinuation of antimicrobial stewardship programme (ASP) activity on the usage pattern of antibiotics. METHODS: An interrupted time-series analysis assessing the trends in antibiotic use was conducted between September 2015 and August 2019 in an 859-bed university-affiliated hospital in Korea, where all ASP activities were discontinued in March 2018. The major activity of the ASP was a restrictive antibiotic programme. RESULTS: The use of restrictive antibiotics increased immediately after the discontinuation of the ASP by 41.06 days of therapy (DOT)/1000 patient-days in the general ward (95% confidence interval (CI) 21.04-61.08) and by 391.04 DOT/1000 patient-days in the intensive care unit (ICU) (95%CI 207.56-574.51). In addition, there were positive changes in the slope for the use of restrictive antibiotics in the general ward (7.06 DOT/1000 patient-days per month, 95%CI 4.63-9.50) and ICU (35.95 DOT/1000 patient-days per month, 95%CI 18.70-53.19). The use of broad-spectrum antibiotics in the general ward significantly decreased (-87.54 DOT/1000 patient-days, 95%CI -149.29 to -25.79). For non-broad-spectrum antibiotics, there were positive changes in the slope in the general ward (16.54 DOT/1000 patient-days per month, 95%CI 12.99-20.09) and ICU (12.85 DOT/1000 patient-days per month, 95%CI 2.32-23.38). CONCLUSIONS: After discontinuation of the ASP, antibiotic usage patterns rapidly returned to the patterns prior to the implementation of the programme.
OBJECTIVES: This study aimed to analyse the effect of discontinuation of antimicrobial stewardship programme (ASP) activity on the usage pattern of antibiotics. METHODS: An interrupted time-series analysis assessing the trends in antibiotic use was conducted between September 2015 and August 2019 in an 859-bed university-affiliated hospital in Korea, where all ASP activities were discontinued in March 2018. The major activity of the ASP was a restrictive antibiotic programme. RESULTS: The use of restrictive antibiotics increased immediately after the discontinuation of the ASP by 41.06 days of therapy (DOT)/1000 patient-days in the general ward (95% confidence interval (CI) 21.04-61.08) and by 391.04 DOT/1000 patient-days in the intensive care unit (ICU) (95%CI 207.56-574.51). In addition, there were positive changes in the slope for the use of restrictive antibiotics in the general ward (7.06 DOT/1000 patient-days per month, 95%CI 4.63-9.50) and ICU (35.95 DOT/1000 patient-days per month, 95%CI 18.70-53.19). The use of broad-spectrum antibiotics in the general ward significantly decreased (-87.54 DOT/1000 patient-days, 95%CI -149.29 to -25.79). For non-broad-spectrum antibiotics, there were positive changes in the slope in the general ward (16.54 DOT/1000 patient-days per month, 95%CI 12.99-20.09) and ICU (12.85 DOT/1000 patient-days per month, 95%CI 2.32-23.38). CONCLUSIONS: After discontinuation of the ASP, antibiotic usage patterns rapidly returned to the patterns prior to the implementation of the programme.