Impact and Sustainability of Antibiotic Stewardship on Antibiotic Prescribing in Visceral Surgery

Overview

Journal Antibiotics (Basel)

Specialty Pharmacology

Date 2021 Dec 24

PMID 34943730

Citations 5

Authors

Magdalena Monika Gruber

Alexandra Weber

Jette Jung

Jens Werner

Rika Draenert

Affiliations

Soon will be listed here.

Abstract

Background: Antibiotic stewardship (AS) ward rounds are a core element in clinical care for surgical patients. Therefore, we aimed to analyze the impact of surgical AS ward rounds on antibiotic prescribing, and the sustainability of the effect after the AS interventions are no longer provided.

Methods: On four wards of the department of visceral surgery, we conducted two independent retrospective prescribing analyses (P1, P2) over three months each. During the study periods, the level of AS intervention differed for two of the four wards (ward rounds/no ward rounds).

Results: AS ward rounds were associated with a decrease in overall antibiotic consumption (91.1 days of therapy (DOT)/100 patient days (PD) (P1), 70.4 DOT/100PD (P2)), and improved de-escalation rates of antibiotic therapy (W1/2: 25.7% (P1), 40.0% (P2), = 0.030; W3: 15.4 (P1), 24.2 (P2), = 0.081). On the ward where AS measures were no longer provided, overall antibiotic usage remained stable (71.3 DOT/100PD (P1), 74.4 DOT/100PD (P2)), showing the sustainability of AS measures. However, the application of last-resort compounds increased from 6.4 DOT/100PD to 12.1 DOT/100PD (oxazolidinones) and from 10.8 DOT/100PD to 13.2 DOT/100PD (carbapenems).

Conclusions: Antibiotic consumption can be reduced without negatively affecting patient outcomes. However, achieving lasting positive changes in antibiotic prescribing habits remains a challenge.

Citing Articles

Time is running out. No excuses to delay implementation of antimicrobial stewardship programmes: impact, sustainability, resilience and efficiency through an interrupted time series analysis (2017-2022).

Fabro G, Venturini S, Avolio M, Basaglia G, Callegari A, Bramuzzo I JAC Antimicrob Resist. 2024; 6(3):dlae072.

PMID: 38752207 PMC: 11094472. DOI: 10.1093/jacamr/dlae072.

Effect and sustainability of a stepwise implemented multidisciplinary antimicrobial stewardship programme in a university hospital emergency department.

Arenz L, Porger A, De Michel M, Weber A, Jung J, Horns H JAC Antimicrob Resist. 2024; 6(1):dlae026.

PMID: 38410248 PMC: 10895698. DOI: 10.1093/jacamr/dlae026.

The Need of Antimicrobial Stewardship in Post-Operative Infectious Complications of Abdominal Surgery.

Obst W, Esser T, Kaasch A, Geginat G, Meyer F, Croner R Visc Med. 2023; 38(5):345-353.

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The impact of antibiotic stewardship interventions and patient related factors on antibiotic prescribing in a vascular surgical department.

Gruber M, Weber A, Jung J, Strehlau A, Tsilimparis N, Draenert R Infection. 2023; 52(1):83-91.

PMID: 37289423 PMC: 10810951. DOI: 10.1007/s15010-023-02056-1.

Sepsis Team Organizational Model to Decrease Mortality for Intra-Abdominal Infections: Is Antibiotic Stewardship Enough?.

Vallicelli C, Santandrea G, Sartelli M, Coccolini F, Ansaloni L, Agnoletti V Antibiotics (Basel). 2022; 11(11).

PMID: 36358115 PMC: 9687019. DOI: 10.3390/antibiotics11111460.

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