15 years of antibiotic stewardship policy in the Nancy Teaching Hospital

The authors report the results of a 15-year antibiotic stewardship policy in the Nancy Teaching Hospital and assess the impact of reinforcing this policy on antibiotic consumption.

Antibiotic stewardship policy was initiated in the mid 90s and then reinforced from 2006 onwards. It was completed by prescription guidelines, nominative prescription of antibiotics, and an operational infectious diseases team (OIDT). The objectives were to promote antibiotic stewardship and decrease the use of extended broad spectrum or costly molecules and intravenous administration. Antibiotics consumption, as defined daily dose per 1000 patient days (DDD/1000PD) and in euros, was monitored from 2005 onwards.

Between 2005 and 2008, overall yearly cost of antibiotics dropped by 34% (-€1,308,902) and consumption in DDD/1000PD by 10%. This drop in consumption concerned all antibiotic classes. Teicoplanin prescription dropped by more than 50% and use of fluoroquinolone IV decreased by 15% in 3years. The operational team's interventions were effective since nearly 80% of suggested prescription amendments were accepted by prescribers.

This experiment shows that it is possible to implement antibiotic stewardship policy. Our results prove a significant decrease in overall consumption of antibiotic, a change in prescribing patterns, with a shift towards the use of cheaper antibiotics.