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 751. Study on Daptomycin Prescription Suitability as a First Step Towards an Antimicrobial Stewardship Program

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S335-S335
Author(s):  
Sebastián García Sánchez ◽  
Félix Jesús García Moreno ◽  
Esther Chamorro de Vega ◽  
Maricela Valerio Minero ◽  
Carmen Guadalupe Rodríguez González ◽  
...  
Keyword(s):  
Antimicrobial Stewardship ◽  
Infection Type ◽  
Tertiary Hospital ◽  
Antimicrobial Stewardship Program ◽  
Osteoarticular Infection ◽  
Stewardship Program ◽  
Adequate Dosage ◽  
Length Of Therapy ◽  
Treatment Adequacy

Abstract Background Daptomycin use has increased since its approval and has often extended to indications not included in the summary of product characteristics with highly variable dosing. Our objective was to assess daptomycin real use in an institution with Pharmacy and ID consultation available and to explore the need for establish specific Daptomycin stewardship. Methods Observational, retrospective study including all patients treated with daptomycin during 2017 in a tertiary hospital. Clinical variables were collected in a pre-established protocol including demographics, comorbidities, infection type, microbiological results, adverse events (AE), outcomes, and treatment adequacy (selection, dosage, microbiological adjustment and duration). Daptomycin prescription is not restricted at our institution. The dosages were considered adequate according to clinical guidelines. Results Overall 176 patients (62% men, median age: 70years) started treatment with daptomycin, 58% of them on empirical bases. Main uses were: skin and soft-tissue infections (37.5%), fever without obvious source (17.6%) and osteoarticular infection (12.5%). Sixty-three patients (35.8%) had concomitant bacteremia. An etiologic diagnosis was reached in 89.2% patients and S.aureuswas the most frequently isolated microorganism (n = 58, and 10 MRSA), followed by CoNS (n = 35). Overall, 77.7% of patients evolved satisfactorily. Five patients discontinued treatment due to AE (urticaria, cholestasis, increased CPK and rhabdomyolysis). Infection-related mortality was 7.4%. Daptomycin was correctly selected in 94.3% patients, length of therapy was adequate in 87.4%. However, only 47.1% of patients received adequate dosage (underdosing in 27.8%) and in 9.8% of patients, the treatment was not adjusted according to microbiological results. The prevalence of daptomycin use was 3.7 patients/1,000 admissions. Conclusion Daptomycin is often prescribed empirically, using nonadequate dosages and duration of therapy needs also an improvement. The follow-up of patients treated with daptomycin should be considered a priority intervention within an Antimicrobial Stewardship Program. Disclosures All authors: No reported disclosures.

Sustainability Failure in the Antimicrobial Stewardship Program in a Secondary Care Hospital from Cuba: A Historical Review of 30 Years and 3 Shots

2020 ◽  
Vol 18 ◽  
Author(s):  
Humberto Guanche Garcell ◽  
Juan José Pisonero Socias ◽  
Gilberto Pardo Gómez
Keyword(s):  
Antimicrobial Stewardship ◽  
Historical Review ◽  
Original Data ◽  
Care Hospital ◽  
Antimicrobial Stewardship Program ◽  
Continuous Quality ◽  
Stewardship Program ◽  
History Of ◽  
Health Organization

Background: During the last 30 years an antimicrobial stewardship program (ASP) was implemented in a facility with periods of weakness. We aim to describe the history of the sustainability failure in the local ASP. Methods: A historical review was conducted using original data from the facility library and papers published. An analysis of factors related to the failure was conducted based on the Doyle approach. Results: The first ASP was implemented from 1989 to 1996 based on the international experiences and contributes to the improvement in the quality of prescription, reduction of 52% in cost and in the incidence of nosocomial infection. The second program restarts in 2008 and decline in 2015, while the third program was guided by the Pan-American Health Organization from 2019. This program, in progress, is more comprehensive than previous ones and introduced as a novel measure the monitoring of antibiotic prophylaxis in surgery. The factors related to the sustainability were considered including the availability of antimicrobials, the leader´s support, safety culture, and infrastructure. Conclusions: The history behind thirty years of experiences in antimicrobial stewardship programs has allowed us to identify the gaps that require proactive strategies and actions to achieve sustainability and continuous quality improvement.

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