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Meropenem antimicrobial stewardship program: clinical, economic, and antibiotic resistance impact
J F García-Rodríguez1, B Bardán-García2, M F Peña-Rodríguez3
1Infectious Diseases Unit. Department of Internal Medicine, University Hospital of Ferrol, Sergas, Ferrol, 15405, La Coruña, Spain. jose.francisco.garcia.rodriguez@sergas.es.
Summary
Implementing a meropenem antibiotic stewardship program (ASP) significantly improved meropenem prescription adequacy and reduced consumption. This led to decreased hospital-acquired multidrug-resistant bloodstream infections and lower mortality rates.
Area of Science:
- Infectious Diseases
- Antimicrobial Stewardship
- Public Health
Background:
- Limited prospective studies evaluate the long-term clinical and antibiotic resistance impact of antibiotic stewardship programs (ASPs).
- Meropenem is a critical broad-spectrum antibiotic, necessitating careful stewardship to preserve efficacy and minimize resistance.
- Hospital-acquired multidrug-resistant (MDR) bloodstream infections (BSIs) pose a significant threat to patient outcomes and healthcare costs.
Purpose of the Study:
- To evaluate the clinical, economic, and ecological impact of a meropenem-focused antibiotic stewardship program (ASP).
- To assess changes in meropenem prescription adequacy, consumption, and associated outcomes, including MDR BSIs and mortality.
- To analyze factors associated with intervention acceptance and their impact on patient care.
Main Methods:
- A descriptive, pre-post intervention study conducted from January 2012 to December 2017.
- Implementation of a meropenem ASP in January 2015, involving infectious disease physician recommendations.
- Prospective data collection on meropenem prescription adequacy, intervention acceptance, meropenem consumption, MDR BSIs, and 30-day mortality.
Main Results:
- Meropenem prescription adequacy and de-escalation to narrower-spectrum antibiotics improved significantly post-ASP implementation (p < 0.001).
- Meropenem consumption decreased by 33% (RR 0.67) during 2015-2017 compared to 2012-2014 (p < 0.001).
- Hospital-acquired MDR BSI rates decreased (RR 0.63, p=0.048), and 30-day mortality in MDR BSIs showed a downward trend (RR 0.45, p=0.096).
Conclusions:
- The meropenem ASP demonstrated sustained clinical, economic, and ecological benefits.
- Improved meropenem use led to reduced costs and mortality associated with hospital-acquired MDR BSIs.
- ASP interventions were accepted in most cases and associated with positive patient outcomes.
Keywords:
Antimicrobial stewardshipBloodstream infectionsCarbapenemsHospital infectionsMultidrug-resistantMore Related Videos
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