Implementation of a care bundle for antimicrobial stewardship

Area of Science:

• Infectious Diseases
• Clinical Pharmacy
• Healthcare Quality Improvement

Background:

• Antimicrobial resistance necessitates optimized antibiotic use.
• Stewardship programs are crucial for improving antibiotic prescribing practices.
• Care bundles offer a structured approach to enhance antibiotic stewardship.

Purpose of the Study:

• To evaluate the impact of an antibiotic-use care bundle on compliance with quality indicators.
• To assess the effectiveness of pharmacist-led interventions in improving antimicrobial therapy.
• To measure changes in antibiotic deescalation and selection of appropriate agents.

Main Methods:

• A prospective study involving patients receiving specific broad-spectrum antibiotics in internal medicine and surgery units.
• Two study phases: intervention (with a stewardship pharmacist) and control (without).
• Stewardship pharmacist performed prospective audits, suggested therapy changes, monitored cultures, and provided education.

Main Results:

• The study evaluated 160 patients and 442 antibiotic orders.
• The pharmacist's interventions were accepted at a 91% rate.
• Compliance with quality indicators increased from 16% to 43% (p < 0.001), with appropriate deescalation rising from 72% to 90% (p = 0.01).

Conclusions:

• Implementing an antimicrobial stewardship program care bundle improved compliance with quality indicators.
• The findings support the integration of stewardship pharmacists into patient care teams.
• This approach enhances the quality and appropriateness of antibiotic therapy.