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Effects of a comprehensive antimicrobial stewardship program in a surgical intensive care unit.
- Source :
-
International Journal of Infectious Diseases . Jul2021, Vol. 108, p237-243. 7p. - Publication Year :
- 2021
-
Abstract
- [Display omitted] • Antibiotics stewardship program (ASP) in the surgical ICU was implemented. • Comprehensive ASP decreased the use of anti-pseudomonal beta-lactams. • Susceptibilities of anti-pseudomonal beta-lactams were improved during ASP period. • Comprehensive ASP was a factor associated with decreased mortality in surgical ICU. • ASP should be implemented to improve antimicrobial use and patient outcome. We evaluated the effects of a comprehensive antimicrobial stewardship program (ASP) in a surgical intensive care unit (SICU). The ASP was implemented from March 2018 to February 2019 at an SICU in a teaching hospital. An infectious disease physician and a pharmacist visited the SICU 3 times per week for prospective audit and feedback. Outcomes were compared between the ASP period and the same months in the preceding year (pre-ASP period). The primary outcome measure was the use of anti-pseudomonal beta-lactams (APBL). Appropriate antimicrobial de-escalation and ICU mortality rates were also compared. A total of 182 and 149 patients were included in the study for the pre-ASP and ASP periods, respectively. Although disease severity was higher in the ASP group (septic shock 39.0% in pre-ASP vs 65.1% in ASP group, P < 0.001), the use of APBL as a definitive treatment was lower during ASP (68.7% vs 57.7%, OR 0.62, 95% CI 0.40–0.98). Appropriate antimicrobial de-escalation improved (63.2% vs 94.6%, P < 0.001). ICU mortality was comparable (7.7% vs 7.4%) and significantly lower during the ASP, after adjustment (adjusted OR 0.41, 95% CI 0.18–0.92, P = 0.032). A comprehensive ASP decreased the use of APBL and was associated with improved patient outcomes. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 12019712
- Volume :
- 108
- Database :
- Academic Search Index
- Journal :
- International Journal of Infectious Diseases
- Publication Type :
- Academic Journal
- Accession number :
- 151557794
- Full Text :
- https://doi.org/10.1016/j.ijid.2021.02.082