Strategically reducing carbapenem-resistant Acinetobacter baumannii through PDCA cycle-driven antibiotic management

Area of Science:

• Clinical microbiology and infectious diseases
• Antimicrobial stewardship
• Healthcare quality improvement

Background:

• Escalating global antibiotic resistance, particularly in Acinetobacter baumannii, necessitates rational carbapenem use.
• Identifying irrational prescribing patterns is key to effective antimicrobial stewardship.
• Acinetobacter baumannii poses a significant threat due to its high resistance rates.

Purpose of the Study:

• To investigate irrationalities in carbapenem antibiotic application using a fishbone diagram.
• To identify factors influencing carbapenem use in clinical settings.
• To implement strategies for rationalizing carbapenem antibiotic utilization.

Main Methods:

• Utilized a fishbone diagram to analyze irrational antibiotic use.
• Implemented targeted intervention strategies based on the analysis.
• Employed a Plan-Do-Check-Act (PDCA) cycle for scientific management.
• Collaborated with antimicrobial stewardship teams and relevant hospital departments.

Main Results:

• Demonstrated a statistically significant increase in the rational use of carbapenem antibiotics post-intervention (P < 0.01).
• Observed a concurrent significant decrease in the detection rates of carbapenem-resistant Acinetobacter baumannii.
• Validated the effectiveness of the PDCA cycle in improving antibiotic prescribing.

Conclusions:

• Continuous refinement through the PDCA cycle effectively minimizes carbapenem usage.
• The PDCA approach leads to a reduction in multidrug-resistant bacteria.
• This strategy fosters rational drug use and enhances healthcare outcomes.