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Antibiotic Dereplication Using the Antibiotic Resistance Platform
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Antibiotic Dereplication Using the Antibiotic Resistance Platform

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Positive effect of restrictions on antibiotic consumption

Oğuz Karabay, Gülsüm Kaya, Ertuğrul Güçlü

    Turkish Journal of Medical Sciences
    |May 2, 2018
    PubMed

    Insights

    Restricting group 2 carbapenems (G2C) significantly reduced hospital-acquired Acinetobacter infections and mortality. Positive infection control behaviors persisted even after restrictions were lifted.

    Area of Science:

    • Infectious Diseases
    • Antimicrobial Stewardship
    • Hospital Epidemiology

    Background:

    • Hospital-acquired infections (HAIs) pose a significant challenge, with carbapenem-resistant organisms being a major concern.
    • Group 2 carbapenems (G2C), including meropenem, imipenem, and doripenem, are critical antibiotics for treating severe infections.
    • Antimicrobial stewardship programs aim to optimize antibiotic use and reduce resistance.

    Purpose of the Study:

    • To evaluate the impact of restricting and subsequently releasing group 2 carbapenem (G2C) prescriptions on the epidemiology of hospital infections.
    • To assess changes in infection rates, particularly Acinetobacter spp. infections, and infection-related mortality during different G2C prescribing periods.
    • To determine if positive changes in antimicrobial use and infection control behaviors are sustained after restriction release.

    Main Methods:

    • A three-period study design was implemented: unrestricted G2C use (SP-1), restricted G2C use (SP-2), and released G2C use (SP-3).
    • Data on hospital infection rates, causative pathogens (specifically Acinetobacter spp.), and infection-related mortality were collected and analyzed across the three periods.
    • Statistical analysis was performed to compare outcomes between the study periods.

    Main Results:

    • A total of 4443 cases were analyzed across the three periods.
    • Overall infection rates decreased significantly from 11% in SP-1 to 6.5% in SP-2, and slightly increased to 7.9% in SP-3 (P = 0.001).
    • Acinetobacter spp. infection rates showed a marked reduction from 3.9% in SP-1 to 1.2% in SP-2, and 1.8% in SP-3 (P = 0.0001). Infection-related mortality also decreased significantly across the periods (7.3% to 5% to 3.8%, P = 0.001).

    Conclusions:

    • Restriction of G2C significantly decreased hospital-acquired Acinetobacter infections, antibiotic consumption, and infection-related mortality.
    • The study demonstrated the effectiveness of antimicrobial stewardship interventions in controlling HAIs.
    • Positive antimicrobial prescribing behaviors and infection control measures adopted during the restriction period were largely maintained after the release of restrictions, suggesting a lasting impact.
    Keywords:
    Restriction of carbapenemantibiotic stewardshipshospital-acquired Acinetobacter infectionsinfection related mortality

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