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Implementation of an Antimicrobial Stewardship Program in the Vascular Surgery Ward of a university tertiary care hospital in Pavia, Northern Italy

Authors :
Marco Vecchia
Marta Colaneri
Paolo Sacchi
Lea Nadia Marvulli
Andrea Salvaderi
Jessica Lanza
Stefano Boschini
Franco Ragni
Piero Marone
Sara Cutti
Alba Muzzi
Carlo Marena
Monica Calvi
Luigia Scudeller
Enrico Maria Marone
Raffaele Bruno
Publication Year :
2022
Publisher :
Research Square Platform LLC, 2022.

Abstract

Purpose The commitment of multidisciplinary teams in antimicrobial stewardship programs (ASPs) is often inadequately considered, especially in surgical wards. We wanted to evaluate clinical, microbiological, and pharmacological outcomes before and after the implementation of an ASP in the Vascular Surgery ward of Fondazione IRCCS Policlinico San Matteo, a tertiary care hospital in Pavia, Italy. Methods This was a quasi-experimental quality-improvement study. The antimicrobial stewardship activity was conducted twice a week for 12 months and consisted of both prospective audit and feedback of all the ongoing antimicrobial prescriptions by the infectious diseases’ consultants and educational meetings for the healthcare workers of the Vascular Surgery ward. For comparison between the study periods, Student t test (Mann–Whitney test for skewed distributions) was used for quantitative variables (ANOVA or Kruskall-Wallis for > 2 groups respectively), and Pearson’s chi-squared test (Fisher exact test where appropriate) for categorical variables. 2-tailed tests were used. P-value significance cut-off was 0.05. Results During the 12-month intervention period, among a total number of 698 patients, 186 prescriptions were revised, mostly leading to de-escalating an ongoing antimicrobial therapy (39, 20.97%). A statistically significant reduction in isolates of carbapenem-resistant Pseudomonas aeruginosa (p-value 0.003) and the absence of Clostridioides difficile infections were reported. No statistically significant changes were observed in terms of length of stay and all-cause in-hospital mortality. A significant decrease in the administration of carbapenems (p-value 0.01), daptomycin (p-value Conclusions The implementation of a 12-month ASP brought significant clinical and economic results, highlighting the benefits of a multidisciplinary teamwork.

Subjects

Subjects :
Infectious Diseases

Details

Database :
OpenAIRE
Accession number :
edsair.doi.dedup.....d50eed153718a797e9adc3ef50b77844
Full Text :
https://doi.org/10.21203/rs.3.rs-1636035/v2