Antimicrobial stewardship program directed at broad-spectrum intravenous antibiotics prescription in a tertiary hospital

2009 ◽  
Vol 28 (12) ◽  
pp. 1447-1456 ◽  
Author(s):  
V. C. C. Cheng ◽  
K. K. W. To ◽  
I. W. S. Li ◽  
B. S. F. Tang ◽  
J. F. W. Chan ◽  
...  
Keyword(s):  
Antimicrobial Stewardship ◽  
Broad Spectrum ◽  
Tertiary Hospital ◽  
Antimicrobial Stewardship Program ◽  
Stewardship Program ◽  
Intravenous Antibiotics

Impact of a 4-year antimicrobial stewardship program implemented in a Greek tertiary hospital

2021 ◽  
Author(s):  
Konstantina Chrysou ◽  
Olympia Zarkotou ◽  
Sofia Kalofolia ◽  
Panagiota Papagiannakopoulou ◽  
Vasiliki Mamali ◽  
...  
Keyword(s):  
Antimicrobial Stewardship ◽  
Tertiary Hospital ◽  
Antimicrobial Stewardship Program ◽  
Stewardship Program

scholarly journals Impact of a comprehensive antimicrobial stewardship program on antimicrobial utilization and clinical isolates distribution in ICUs

2020 ◽  
Author(s):  
Jiaojiao Song ◽  
Rongsheng Zhu ◽  
Leiqing Li ◽  
Lingcheng Xu ◽  
Quan Zhou ◽  
...  
Keyword(s):  
Antimicrobial Stewardship ◽  
Broad Spectrum ◽  
Second Generation ◽  
Antimicrobial Treatment ◽  
Clinical Isolates ◽  
Antimicrobial Use ◽  
Antimicrobial Stewardship Program ◽  
Stewardship Program ◽  
Antimicrobial Utilization ◽  
Lactamase Inhibitor

Abstract Objective This study aimed to evaluate the effect of a comprehensive antimicrobial stewardship program (ASP) and provide clinical evidence for the scientific stewardship of antimicrobials in intensive care units (ICUs) of a teaching hospital.Methods Between January 2013 and December 2018, we conducted a prospective study, based on an antimicrobial computerized clinical decision support system (aCDSS) deployed in 2015 in ICUs of a tertiary and teaching hospital. The primary outcomes included initial and overall use prevalence of antimicrobials. The second outcomes were the detection rate of common clinical isolates before and after therapeutic antimicrobial use, and the change in patterns of resistance of 5 common clinical isolates in the ICU.Results Various types of broad-spectrum antimicrobial use prevalence continued to increase from 2013 to 2015, since 2016, where initial use of carbapenems and glycopeptides were counterbalanced by an increase in use of the first/second-generation cephalosporins, β-lactam and β-lactamase inhibitor combinations and linezolid. From 2015 to 2018, the proportion of extended-broad spectrum antimicrobials alone, wide-coverage therapy and combination therapy decreased significantly (P<0.05). Similarly, where use of carbapenems, glycopeptides, third/fourth-generation cephalosporins and anti-fungi agents were counterbalanced by an increase in overall use of the first/second-generation cephalosporins and β-lactam and β-lactamase inhibitor combinations. A total of 21891 strains of bacteria and fungi were detected in ICUs from 2015 to 2018, of them, 6.5% (1426/21891) strains were detected before antimicrobial treatment. The detection proportion of Staphylococcus aureus , Escherichia coli , Klebsiella pneumoniae and fastidious bacteria were significantly higher before antimicrobial treatment (P<0.05), while Acinetobacter baumannii , Burkholderia cepacia , and Candida spp were significantly lower in all non-repetitive clinical isolates (P<0.05).Conclusions The implementation of a comprehensive ASP combining CDSS in ICUs seems to be effective to improve outcomes on antimicrobial utilization and clinical isolates distribution in critically ill patients.

scholarly journals 1055. Addition of Antimicrobial Stewardship Program Weekend Coverage Increases Interventions while Reducing Antimicrobial Duration and Cost

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S372-S373
Author(s):  
Natasha N Pettit ◽  
Jennifer Pisano ◽  
Cynthia T Nguyen
Keyword(s):  
Antimicrobial Stewardship ◽  
Broad Spectrum ◽  
Total Duration ◽  
Time Frame ◽  
Antimicrobial Stewardship Program ◽  
Clinical Pharmacists ◽  
Duration Of Therapy ◽  
Stewardship Program ◽  
Secondary Outcomes ◽  
The Impact

Abstract Background Expansion of Antimicrobial Stewardship Program (ASP) activities to include coverage of weekends has been shown to facilitate further optimization of antimicrobial usage. Beginning July 2018, we implemented full ASP coverage on weekends from 0700–1530 by infectious diseases (ID) clinical pharmacists and pharmacy residents. We sought to evaluate the impact of the addition of weekend ASP coverage on the number of interventions, antimicrobial duration and cost of target broad-spectrum antimicrobials. Methods Antimicrobials reviewed by ASP on a weekend day between July 14, 2018 and December 16, 2018 were included in the analysis. The primary outcome was the number and type of documented interventions associated with the antimicrobials reviewed. Secondary outcomes included the total duration of meropenem, daptomycin, and micafungin initiated on a weekend, estimated expenditures on these target broad-spectrum antimicrobials, and comparison of the average number of interventions performed per day by ID clinical pharmacists vs. pharmacy residents. For comparison, we also evaluated these secondary outcomes prior to ASP weekend coverage, between July 16, 2017 and December 9, 2017. Results A total of 688 antimicrobials were reviewed on weekend days during the included time-frame with 753 interventions (average number of interventions/day: 37). Table 1 summarizes the type of interventions. The acceptance rate for interventions was 99%. The average number of interventions per day for ID clinical pharmacists vs. pharmacy residents was 57.9 and 26.2, respectively. Table 2 shows the total duration of therapy (DOT) and total expenditures on target antimicrobials before and after ASP weekend coverage. The total DOT of target antimicrobials agents decreased from 21 days to 7 days, with an estimated 3,165 dollar decrease in expenditures during the included time-frame. Conclusion Expansion of ASP coverage to include weekends allowed us to provide 753 interventions over 4 months that would not otherwise have been made when no ASP coverage was available. This was associated with a reduction in broad-spectrum antimicrobial duration of therapy and expenditures when compared with weekends where ASP weekend coverage was not available. Disclosures All authors: No reported disclosures.

Antimicrobial Stewardship in the Emergency Department

2011 ◽  
Vol 24 (2) ◽  
pp. 196-202 ◽  
Author(s):  
Nicole M. Acquisto ◽  
Stephanie N. Baker
Keyword(s):  
Emergency Department ◽  
Emergency Medicine ◽  
Antimicrobial Stewardship ◽  
Broad Spectrum ◽  
Antimicrobial Stewardship Program ◽  
Implementation Outcomes ◽  
Stewardship Program ◽  
Assessment Skills ◽  
Barriers To Implementation

The practice of antimicrobial stewardship can be defined as optimizing clinical outcomes while minimizing the consequences of antimicrobial therapy such as resistance and superinfection. Antimicrobial stewardship can be difficult to transition to the emergency department (ED) since the traditional activities include the evaluation of broad-spectrum antimicrobial regimens at 72 and 96 hours and intravenous to oral medication conversion. The emergency medicine clinical pharmacist (EPh) has the knowledge and clinical assessment skills to manage an antimicrobial stewardship program focused on culture follow-up for patients discharged from the ED. This paper summarizes the experiences of developing an EPh-managed antimicrobial stewardship and culture follow-up program in the ED from 2 separate institutions. Specifically, the focus is on the steps for establishing an EPh-managed antimicrobial stewardship program, a description of the culture follow-up process, managing the culture data and cultures that require emergent notification and review, medical/legal concerns, and barriers to implementation. Outcomes data available from institutions with similar ED based antimicrobial stewardship programs are also discussed.

scholarly journals PRESCRIBING PATTERN OF INTRAVENOUS ANTIBIOTICS FOR HOSPITALIZED PATIENT IN HOSPITAL JERANTUT

2021 ◽  
Vol 5 (3) ◽  
Author(s):  
Sumaiyah Abdul Aziz ◽  
Sumaiyah Abdul Aziz ◽  
Sumaiyah Abdul Aziz
Keyword(s):  
Antimicrobial Stewardship ◽  
Hospitalized Patients ◽  
Antimicrobial Stewardship Program ◽  
Prescribing Pattern ◽  
Stewardship Program ◽  
Intravenous Antibiotics ◽  
Hospitalized Patient

Hospitalized patients are often prescribed with antibiotics and it can be a challenge for the prescriber. This study is conducted to review the prescribing pattern of intravenous antibiotics for hospitalized patients in Jerantut Hospital in accordance to the National Antibiotic Guideline and Antimicrobial Stewardship Program.

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