[Antibiotic stewardship in a basic care hospital : A retrospective observational study]

Area of Science:

• Infectious Diseases
• Hospital Administration
• Microbiology

Background:

• Global rise in antibiotic resistance necessitates effective antibiotic stewardship (ABS).
• Previous ABS studies focused mainly on university hospitals.
• This study evaluates ABS implementation in a basic care hospital setting.

Purpose of the Study:

• To describe the implementation of an antibiotic stewardship program in a basic care hospital.
• To evaluate the impact of ABS on antibiotic consumption, resistance rates, and clinical outcomes.

Main Methods:

• Retrospective observational study comparing pre- and post-intervention data.
• Implementation of national guidelines, including an ABS team, hospital guidelines, education, ward rounds, and restricted antibiotics.
• Analysis of antibiotic use, blood cultures, resistance, Clostridium difficile infection, costs, mortality, and length of stay.

Main Results:

• Total antibiotic use decreased by 43 RDD/100 PD to 31 RDD/100 PD (p < 0.001).
• Significant reductions observed in cephalosporins, carbapenems, and quinolones.
• E. coli resistance to 3G cephalosporins in blood cultures decreased from 26% to 9% (p = 0.021).
• Blood culture rates increased by 77% (p < 0.001), enhancing pathogen detection.

Conclusions:

• ABS implementation led to reduced antibiotic consumption and lower resistance rates.
• Optimized diagnostic procedures were indicated by increased blood culture rates.
• Basic care hospital structures appear suitable for hospital-wide ABS concepts, even with limited resources.