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Digestive and Liver Disease
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Digestive and Liver Disease
Article . 2016 . Peer-reviewed
License: Elsevier TDM
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Antimicrobial stewardship in a Gastroenterology Department: Impact on antimicrobial consumption, antimicrobial resistance and clinical outcome

Authors: Bedini, Andrea; De Maria, Nicola; Del Buono, Mariagrazia; BIANCHINI, Marcello; Mancini, Mauro; Binda, Cecilia; Brasacchio, Andrea; +9 Authors

Antimicrobial stewardship in a Gastroenterology Department: Impact on antimicrobial consumption, antimicrobial resistance and clinical outcome

Abstract

A major cause of the increase in antimicrobial resistance is the inappropriate use of antimicrobials.To evaluate the impact on antimicrobial consumption and clinical outcome of an antimicrobial stewardship program in an Italian Gastroenterology Department.Between October 2014 and September 2015 (period B), a specialist in infectious diseases (ID) controlled all antimicrobial prescriptions and decided about the therapy in agreement with gastroenterologists. The defined daily doses of antimicrobials (DDDs), incidence of MDR-infections, mean length of stay and overall in-hospital mortality rate were compared with those of the same period in the previous 12-months (period A).During period B, the ID specialist performed 304 consultations: antimicrobials were continued in 44.4% of the cases, discontinued in 13.8%, not recommended in 12.1%, de-escalated 9.9%, escalated in 7.9%, and started in 4.0%. Comparing the 2 periods, we observed a decreased of antibiotics consumption (from 109.81 to 78.45 DDDs/100 patient-days, p=0.0005), antifungals (from 41.28 to 24.75 DDDs/100pd, p=0.0004), carbapenems (from 15.99 to 6.80 DDDsx100pd, p=0.0032), quinolones (from 35.79 to 17.82 DDDsx100pd, p=0.0079). No differences were observed in incidence of MDR-infections, length of hospital stay (LOS), and mortality rate.ASP program had a positive impact on reducing the consumption of antimicrobials, without an increase in LOS and mortality.

Countries
Belgium, Italy
Keywords

Adult, Male, Medication Therapy Management, Antifungals; Antimicrobial stewardship; Carbapenems; Gastroenterology; MDR-microorganisms; Adult; Aged; Aged, 80 and over; Anti-Infective Agents; Drug Resistance, Microbial; Drug Utilization; Female; Gastroenterology; Hospital Mortality; Humans; Italy; Length of Stay; Linear Models; Male; Medication Therapy Management; Middle Aged; Prospective Studies; Referral and Consultation; Young Adult; Hepatology; Gastroenterology, antifungals; antimicrobial stewardship; carbapenems; gastroenterology; MDR-microorganisms, Young Adult, Anti-Infective Agents, Humans, Antifungals; Antimicrobial stewardship; Carbapenems; Gastroenterology; MDR-microorganisms, Hospital Mortality, Prospective Studies, Referral and Consultation, Aged, Aged, 80 and over, Gastroenterology, Drug Resistance, Microbial, Length of Stay, Middle Aged, Drug Utilization, Italy, Linear Models, Female

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
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