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Published on: August 30, 2018
Effects of a Primary Care Antimicrobial Stewardship Program on Meticillin-Resistant Staphylococcus aureus Strains
Alfredo Jover-Sáenz1, María Ramírez-Hidalgo1, Alba Bellés Bellés2
1Unidad Territorial Infección Nosocomial (UTIN), Hospital Universitari Arnau de Vilanova de Lleida (HUAV), 25198 Lleida, Spain.
Abstract:
Primary care antimicrobial stewardship program (ASP) interventions can reduce the over-prescription of unnecessary antibiotics, but the impact on the reduction in bacterial resistance is less known, and there is a lack of available data. We implemented a prolonged educational counseling ASP in a large regional outpatient setting to assess its feasibility and effectiveness. Over a 5-year post-implementation period, which was compared to a pre-intervention period, a significant reduction in antibiotic prescriptions occurred, particularly those associated with greater harmful effects and resistance selection. There was also a decrease in methicillin-resistant Staphylococcus aureus (MRSA) strains and in their co-resistance to other antibiotics, particularly those with an ecological impact.
Insights
Primary care antimicrobial stewardship programs (ASP) effectively reduce antibiotic over-prescription. This study shows ASPs also decrease bacterial resistance, including methicillin-resistant Staphylococcus aureus (MRSA), and co-resistance to other antibiotics.
Area of Science:
- Infectious Diseases
- Public Health
- Clinical Pharmacy
Background:
- Antimicrobial resistance (AMR) is a growing global health threat.
- Primary care settings are significant contributors to antibiotic overuse.
- The impact of antimicrobial stewardship programs (ASPs) on resistance reduction in outpatient settings requires further investigation.
Purpose of the Study:
- To assess the feasibility and effectiveness of a prolonged educational counseling ASP in a large regional outpatient setting.
- To evaluate the impact of the ASP on antibiotic prescription patterns and bacterial resistance.
- To analyze changes in methicillin-resistant Staphylococcus aureus (MRSA) prevalence and co-resistance.
Main Methods:
- Implementation of a 5-year educational counseling ASP in a primary care setting.
- Comparison of antibiotic prescription data from a 5-year post-intervention period with a pre-intervention period.
- Monitoring of bacterial resistance patterns, including MRSA strains and co-resistance.
Main Results:
- A significant reduction in overall antibiotic prescriptions was observed post-implementation.
- Prescriptions for antibiotics with higher risks of harmful effects and resistance selection were particularly reduced.
- A notable decrease in MRSA strains and their co-resistance to other antibiotics was documented.
Conclusions:
- Prolonged educational counseling ASPs are feasible and effective in primary care.
- ASPs can significantly reduce antibiotic use and mitigate the development of bacterial resistance, including MRSA.
- ASPs contribute to reducing co-resistance, particularly for antibiotics with ecological impact.
