An antibiotic stewardship program in a French teaching hospital

Area of Science:

• Infectious Diseases
• Hospital Administration
• Public Health

Background:

• Antibiotic resistance is a growing global health concern.
• Effective antibiotic stewardship programs are crucial for optimizing antibiotic use and combating resistance.
• Teaching hospitals play a key role in implementing and evaluating such programs.

Purpose of the Study:

• To describe the organization and interventions of an antibiotic stewardship program implemented in a teaching hospital.
• To evaluate the impact of the program on antibiotic prescribing patterns over a 10-year period.
• To assess physician acceptance and the program's effectiveness in controlling antibiotic use.

Main Methods:

• An observational study design was employed over a decade (2002-2011).
• Key interventions included Infectious Diseases Specialist (IDS) ward rounds, nominative antibiotic order forms, electronic medical record documentation, and pharmacist-triggered alerts.
• Data on antibiotic advice and usage (defined daily doses per 1000 patient-days) were collected and analyzed.

Main Results:

• Over 7,200 pieces of advice were recorded between 2007-2011, primarily physician-requested (63%) and IDS-provided (95%).
• The number of antibiotic prescriptions remained stable around 400 DDD/1000 patient-days since 2005.
• Implementation of a database improved documentation, sharing of advice, and decision-making.

Conclusions:

• The antibiotic stewardship program is well-accepted by physicians.
• The program effectively controls antibiotic use within the teaching hospital.
• Sustained stewardship efforts are vital for managing antibiotic consumption and potentially mitigating resistance.