Antimicrobial stewardship reduces antibiotic use density and cost in a Chinese tertiary hospital

Antimicrobial Stewardship Programs (ASP) have demonstrated efficacy in lowering hospital expenditures and enhancing the judicious use of antibiotics. However, many hospitals in China have not yet established an ASP management model, and there is limited literature reporting successful ASP experiences. This study aimed to investigate the impact of ASP on Antibiotics Use Density (AUD). We conducted a retrospective study from October 2023 to September 2024 in a tertiary general hospital in Hangzhou, China. Based on audits of antibiotic orders conducted from October 1, 2023, to March 31, 2024, we identified potential factors contributing to high AUD. In line with the guidelines for implementing ASP, we established an ASP team and implemented comprehensive improvement strategies from April 1, 2024, to September 30, 2024. Following the implementation of ASP, the AUD decreased significantly by 31.01% from 54.20 prior to intervention to 37.39 post-intervention. The total Defined Daily Doses (DDD_S) declined by 30.06% from 98,311.52 to 68,751.82, while the total cost of antibiotics fell by 5.81% from $1,798,309.53 to $1,693,918.44. Among 33 clinical departments within the hospital, 31 demonstrated a reduction in AUD. Furthermore, the AUD proportion of tetracyclines and quinolone antibacterials decreased from 6.68 to 2.54% and from 25.63 to 21.10%, respectively. This study demonstrates that ASP is a viable and effective approach for reducing AUD and DDD_S of antibiotics, as well as lowering the overall cost of antibiotics, and has the potential to enhance the quality of antimicrobial prescribing.