Logistic Stewardship: Supporting Antimicrobial Stewardship Programs Based on Antibiotics Goods Flow

Area of Science:

• Healthcare Management
• Infectious Disease Control
• Clinical Pharmacy

Background:

• Antimicrobial resistance is a critical global health threat, necessitating reduced antibiotic consumption.
• Voluntary reporting of hospital antibiotic consumption in Germany shows limited impact on median consumption levels.
• The accuracy of logistical consumption data in reflecting actual antibiotic use requires investigation.

Purpose of the Study:

• To evaluate if logistical antibiotic consumption data (defined daily doses - DDDs) accurately represent real-world usage (prescribed daily doses - PDDs).
• To identify patterns in antibiotic goods flow that explain discrepancies between PDDs and DDDs.
• To provide recommendations for optimizing antimicrobial stewardship (AMS) programs using logistical data.

Main Methods:

• A six-month analysis of four hospital wards.
• Comparison of PDDs from patient records with DDDs from logistical data.
• Inventory assessments to account for stored antibiotics and analysis of antibiotic goods flows using waterfall diagrams.
• Evaluation of AMS quality indicators to inform optimized clinical AMS measures.

Main Results:

• The overall PDD/DDD quotient was 0.69, indicating lower prescribed use than logistical data suggested.
• Four distinct logistical patterns were identified.
• Optimized prophylaxis, antimicrobial stewardship consultations, and therapy reevaluation were identified as key measures to reduce PDDs.

Conclusions:

• Antimicrobial stewardship programs relying solely on DDDs may not achieve optimal outcomes.
• Integrating antibiotic goods flow data enhances clinical decision-making but involves significant data collection costs.
• Logistical data analysis is crucial for identifying focus areas within AMS programs.
• Collaboration between antibiotic logistics specialists and clinical AMS teams is recommended for comprehensive antibiotic management.