Unit:
Faculty of MedicineLibrary of the School of Health Sciences
Author:
Chrysou Konstantina
Dissertation committee:
Σπύρος Πουρνάρας, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Αθανάσιος Τσακρής, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Νικόλαος Σύψας, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Σωτήριος Τσιόδρας, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Γεωργία Βρυώνη, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Aντώνιος Παπαδόπουλος, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Ευαγγελία Δημητρούλια, Επίκουρη Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Διερεύνηση της αποτελεσματικότητας της εφαρμογής προγράμματος διαχείρισης αντιβιοτικών (antibiotic stewardship program) σε τριτοβάθμιο γενικό νοσοκομείο
Translated title:
Evaluation of the effectiveness of the implementation of an antibiotic stewardship program in a tertiary general hospital
Summary:
The aim of this study was to investigate the effect of the implementation of an antibiotic stewardship program (ASP) on antibiotic consumption in our 427-bed hospital. The Infection Control Committee implemented an ASP beginning in January 2016, aiming to reduce inappropriate antibiotic use through improved prescribing practices.
The ASP included both pre-authorization and prospective audit and feedback strategies. We collected pharmacy and hospital data for the years 2015 (pre-intervention) and 2016-2019 (post-intervention). Consumption data were expressed as daily defined doses (DDDs) per 100 patient-days (PD) and the significance of the differences between 2015 and 2016-2019 was assessed by paired t-Τest analysis. Antibiotic resistance rates for the most important hospital pathogens were monitored for years 2015–2019.
The ASP effectively reduced consumption of most antibiotics; total antibiotic use decreased by 14.83% (from 90.88 in 2015 to 77.40 DDDs / 100 PD in 2016, with a decrease of 16.03% for the common (unprotected) and 13.76% for the protected antibiotics. The average decrease for the years 2016-2019 was 8.23% (p=0.034), that is 7.87% for the common (p=0.138) and 8.58% (p=0.05) for the protected antibiotics. Important restricted antimicrobials, such as colistin, carbapenems, quinolones and tigecycline showed significantly decreased usage post-intervention. Significant changes in the resistance rates were not observed, except a decreasing trend for colistin and tigecycline (Acinetobacter baumannii and Klebsiella pneumoniae) and also for vancomycin (enterococci).
The ASP was successful in terms of reducing the antibiotic consumption, especially for the first year of its implementation which was maintained for the next three years. Interestingly, antibiotics requiring pre-authorization exhibited a lower reduction than other antibiotics, apparently because the specific antibiotics needed pre-authorization even before the implementation of the ASP. Potential effects of the ASP in reducing resistance rates remain to be shown.
Main subject category:
Health Sciences
Keywords:
Antibiotic stewardship, Antimicrobial stewardship, Antibiotic cost, Antibiotic consumption, Antimicrobial resistance
Number of references:
172
