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The impact of earlier intervention by an antimicrobial stewardship team for specific antimicrobials in a single

D Hagiwara1, K Sato1, M Miyazaki2

  • 1Department of Pharmacy, Fukuoka University Hospital, Fukuoka, Japan.

International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases
|October 8, 2018
PubMed
Abstract

Insights

Earlier antimicrobial stewardship team (AST) intervention significantly reduced antimicrobial use and resistance rates, including carbapenem resistance in Pseudomonas aeruginosa. Patient outcomes remained unaffected, demonstrating the benefits of prompt AST involvement.

Area of Science:

  • Infectious Diseases
  • Hospital Pharmacy
  • Clinical Microbiology

Background:

  • Antimicrobial resistance is a growing global health threat.
  • Antimicrobial stewardship programs (ASPs) are crucial for optimizing antimicrobial use.
  • The impact of early intervention by antimicrobial stewardship teams (ASTs) on resistance and clinical outcomes requires further investigation.

Purpose of the Study:

  • To evaluate the effects of earlier AST intervention on antimicrobial usage, resistance patterns, and patient outcomes.
  • To assess if a shortened intervention timeline impacts antimicrobial use density (AUD) and associated costs.
  • To determine the influence of early AST involvement on resistance rates of specific pathogens and overall patient mortality and length of stay.

Main Methods:

  • A retrospective study was conducted at Fukuoka University Hospital from April 2013 to March 2016.
  • Three study periods (SP1, SP2, SP3) were defined based on patient cohorts receiving specific antimicrobials and treatment durations.
  • Intervention timing, antimicrobial use density (AUD), resistance rates, mortality, and length of stay were compared across the study periods.

Main Results:

  • The timing of AST intervention was significantly reduced from 15.5 days in SP1 to 4.2 days in SP3.
  • Antimicrobial use density (AUD) of carbapenems and piperacillin-tazobactam decreased significantly between SP2 and SP3 (p<0.05).
  • Carbapenem resistance rates in Pseudomonas aeruginosa isolates decreased from 16.2% in SP2 to 8.7% in SP3 (p<0.05), with a notable reduction in antimicrobial costs.

Conclusions:

  • Earlier intervention by an antimicrobial stewardship team (AST) is associated with reduced antimicrobial use and resistance.
  • Prompt AST involvement can lead to significant cost savings in antimicrobial procurement.
  • Early AST intervention does not adversely affect patient mortality or length of stay, supporting its clinical utility.
Keywords:
Antimicrobial resistanceAntimicrobial stewardship programAntimicrobial use densityCostPseudomonas aeruginosa

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