scholarly journals Practice of antimicrobial stewardship in a government hospital of India and its impact on extended point prevalence of antibiotic usage

2021 ◽  
Vol 10 (2) ◽  
pp. 991
Author(s):  
Sagar Khadanga ◽  
Shweta Kumar ◽  
Karuna Tadepalli ◽  
Rajnish Joshi ◽  
Manisha Shrivastava ◽  
...  
Keyword(s):  
Antimicrobial Stewardship ◽  
Antibiotic Usage ◽  
Point Prevalence ◽  
Government Hospital ◽  
Extended Point

scholarly journals 19. A Global Point Prevalence Survey of Antimicrobial Use in Neonatal Intensive Care Units

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S10-S10
Author(s):  
Pavel Prusakov ◽  
Debra A Goff ◽  
Phillip Wozniak ◽  
Pablo J Sanchez
Keyword(s):  
Antimicrobial Stewardship ◽  
Antimicrobial Therapy ◽  
Point Prevalence ◽  
Initial Assessment ◽  
Definitive Treatment ◽  
P Value ◽  
Antimicrobial Use ◽  
Site Location ◽  
Prevalence Survey ◽  
Research Grant

Abstract Background Antimicrobials are one of the most commonly used medications in the NICU. We aimed to gather baseline global data on antimicrobial use to facilitate subsequent antimicrobial stewardship efforts. Methods We conducted a one-day global NICU point prevalence study on July 1, 2019 with a 30-day follow up. Data collection included patient demographics, antimicrobial therapy, site location, antimicrobial stewardship (AS) practices as well as the duration of antimicrobial therapy and in-hospital mortality were recorded. Results Eighty-one NICUs from twenty-eight different countries identified 2,163 admitted patients of which 570 (26%) were prescribed at least one antimicrobial. Three NICUs did not have any patients on antimicrobial therapy, all had less than 20 patients admitted. Level 3 and Level 4 NICUs comprised 51% and 48% respectively. Delivery units comprised 74%, the rest were referral centers. AS programs were in place in 62% of the hospitals and 47% of the units had NICU specific initiatives. Patients were on average 32.5 weeks gestational age (+/-5.3 SD), with birth weight of 1976 grams (+/- 1022 SD), and were 32 days (+/-65 SD) postnatal age at the time of the study. Antibiotics were the most frequently used medication in 92% of patients with 931 antibiotics prescribed on the assessment day. Hospitals with any NICU AS initiative had significantly lower rates of antibiotic utilization compared to NICUs without AS (21% and 32%; p-value: < 0.01). Of those on antibiotic therapy, ampicillin, gentamicin and amikacin were prescribed to 41%, 34%, and 21% of patients respectively. When only definitive treatment was evaluated, vancomycin, amikacin, and meropenem were the highest prescribed antibacterial agents at 25%, 19%, and 19% respectively. At the initial assessment, study participants indicated either 3 or 7 days (37% and 26%) for planned duration. Actual treatment duration for empiric and definitive treatment, was 7 and 14 days (29% and 19%) When comparing patients who had an established treatment course at the time of the initial assessment, the final length of treatment for culture negative sepsis was 7 (IQR:5–10) and culture positive sepsis was 11 days (IQR:10–14; p-value: 0.07). Conclusion Benchmarking global antimicrobial use is crucial for improving NICU-AS practices. Disclosures Pavel Prusakov, PharmD, Merck (Research Grant or Support) Debra A. Goff, PharmD, Merck (Research Grant or Support)

Point-Prevalence Study Relating to Antibiotic Usage in Dr. Behçet Uz Children Hospital; Comparison of 2008 and 2012 Data

2012 ◽  
Vol 6 (2) ◽  
pp. 46-49 ◽  
Author(s):  
İlker Devrim ◽  
Gamze Gülfidan ◽  
Yeliz Oruç ◽  
Nevbahar Yaşar ◽  
Yelda Sorguç ◽  
...  
Keyword(s):  
Antibiotic Usage ◽  
Point Prevalence ◽  
Prevalence Study ◽  
Point Prevalence Study ◽  
Hospital Comparison

scholarly journals Knowledge, Attitude and Practices of Clinicians, Nurses and Pharmacists Regarding Antimicrobial Stewardship: A Five Centre Survey from India

2021 ◽  
Author(s):  
Akshata Mane ◽  
Shweta Kamat ◽  
Harish Thanusubramanian
Keyword(s):  
Antimicrobial Stewardship ◽  
Bacterial Infections ◽  
Descriptive Analysis ◽  
Healthcare Providers ◽  
Antibiotic Use ◽  
Antibiotic Usage ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Kap Survey ◽  
Wide Range

Introduction: Increasing awareness and practice of Antimicrobial Stewardship (AMS) has gained immense importance in Indian hospitals for preventing the irrational use of antibiotics. India is one of the world’s largest consumers for antibiotics. Assessment of the local Knowledge, Attitude and Practices (KAP) of Antimicrobial Resistance (AMR) and AMS among Healthcare Providers (HCPs) will help in designing effective public health policies and engaging the community in campaigns against increasing microbial resistance. Aim: To understand the status of AMS programs and practices in five private sector multispecialty hospitals situated in the East, West, North and South zones of the country and to assess the KAP of HCPs regarding AMR and AMS. Materials and Methods: The cross-sectional survey was conducted to assess the implementation of AMS in five hospitals among clinicians, nurses and pharmacists across India using a predeveloped AMS checklist between June 2019 and October 2019. The analysis was done between July and August 2020. Responses were collected using a five-point Likert scale, with choices ranging from ‘strongly agree’ to ‘strongly disagree’.Descriptive analysis was done for the KAP survey to determine the percentages of participants under each response category. Results: Total 32 clinicians, 55 nurses and eight pharmacists responded to the KAP survey (100% response rate). The clinicians were aware that AMR is caused by irrational prescribing of antimicrobials (n=31, 96.87%) and improper diagnosis of infective conditions (n=27, 84.37%). However, knowledge of clinicians on infection control practices (n=6, 18.75% disagreed) in controlling AMR and practice of referring local epidemiology before prescribing antimicrobials (n=7, 21.87% did not follow routinely) could be improved. The knowledge and practice of nurses and pharmacists on antibiotic use were spread over a wide range. According to the nurses, AMR was mainly caused by using antimicrobials for non bacterial infections (n=30, 54.54%) and deviations from their standard duration (~63.64%-72.73%). As per pharmacists, the lack of restrictions on antimicrobial usage and widespread use or overuse of antibiotics were major contributors to AMR (n=3, 37.5% strongly agreed). Both nurses and pharmacists could benefit from reinforced training on antibiotic usage. Conclusion: Implementation of AMS was not adequate in private Indian hospitals. Although clinicians have good knowledge on antibiotic use, it was not equally reflected in their practice. The KAP data of nurses and pharmacists suggest that training and education on appropriate antibiotic usage should be emphasised. More efforts are required to improve AMS practices in hospitals.

scholarly journals Implementation and Impact of an Antimicrobial Stewardship Program at a Non-freestanding Children's Hospital

2018 ◽  
Vol 23 (2) ◽  
pp. 84-91 ◽  
Author(s):  
J. Michael Klatte ◽  
Kathleen Kopcza ◽  
Alexander Knee ◽  
Evan R. Horton ◽  
Erica Housman ◽  
...  
Keyword(s):  
Antimicrobial Stewardship ◽  
Interrupted Time Series ◽  
Antibiotic Use ◽  
Antibiotic Usage ◽  
Control Group ◽  
Children's Hospital ◽  
Hospital Readmission Rates ◽  
Stewardship Program ◽  
Children’S Hospital ◽  
Acceptance Rates

OBJECTIVES Pediatric Antimicrobial Stewardship Programs (ASP) have been associated with improvements in antibiotic utilization and patient outcomes; however, ASP studies originating from non-freestanding children's hospitals are lacking. In this study, we present the implementation and impact of a multidisciplinary ASP that employs a collaborative physician and pharmacist driven thrice-weekly prospective audit-with-feedback approach at a non-freestanding children's hospital. METHODS Implementation was assessed via descriptive design. Pediatric inpatients maintained on predefined targeted antibiotics of interest for 48 to 72 hours preceding ASP review were eligible for inclusion. Outcomes evaluated included ASP recommendation and provider acceptance rates (overall and by antibiotic and provider specialty). Impact was examined using an interrupted time series design (with a preimplementation period of August 1, 2013, to July 31, 2014 and postimplementation period of December 1, 2014 to May 31, 2016). Eligibility included all targeted antibiotic usage among pediatric inpatients, with a control group comprising those who received antibiotics requiring preauthorization. Outcomes analyzed included days of antibiotic therapy per 1000 patient days (DOT/1000 PD) and 30-day hospital readmission rates over time. RESULTS Postimplementation, 882 antibiotic reviews were performed on 637 patients, with 327 recommendations generated. Reviews of patients maintained on vancomycin and clindamycin, and of those under care of intensivist and hospitalist physicians, were most likely to prompt recommendations. A mean targeted antibiotic usage decrease of 24.8 DOT/1000 PD (95% confidence interval, −62 to 14) was observed postimplementation, with no change in 30-day readmissions (0.64% during both periods). CONCLUSIONS ASP implementation at a non-freestanding children's hospital was feasible and allowed for identification of areas for targeted quality improvement, while demonstrating modest antibiotic use reduction without adversely impacting patient care.

scholarly journals Impact of Antibiotic Usage on Extended-Spectrum ß-Lactamase Producing Escherichia Coli Prevalence: A Time-Series Analysis of Tertiary Hospital Implementing Stewardship Program

2021 ◽  
Author(s):  
Jeong Yeon Kim ◽  
Yun Jin Yum ◽  
Hyung Joon Joo ◽  
Hyonggin An ◽  
Jong Hun Kim ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Time Series ◽  
Antimicrobial Resistance ◽  
Time Series Analysis ◽  
Antimicrobial Stewardship ◽  
Antibiotic Usage ◽  
E Coli ◽  
Series Analysis ◽  
Extended Spectrum ◽  
Hospital Acquired

Abstract An increase in antibiotic usage is considered to attribute to the emergence of antimicrobial resistance. Although experts are counting on the antimicrobial stewardship programs to reduce antibiotic usage, their effect remains uncertain. In this study, we aimed to evaluate the impact of antibiotic usage and forecast the prevalence of hospital-acquired extended spectrum β-lactamase (ESBL) - producing Escherichia coli (E. coli) using time-series analysis. Antimicrobial culture information of E. coli was obtained using a text processing technique that helped extract free-text electronic health records from standardized data. The antimicrobial use density (AUD) of antibiotics of interest was used to estimate the quarterly antibiotic usage. Transfer function model was applied to forecast relationship between antibiotic usage and ESBL-producing E. coli. Of the 1,938 hospital-acquired isolates, 831 isolates (42.9%) were ESBL-producing E. coli. Both the proportion of ESBL-producing E. coli and AUD increased over time. The transfer model predicted that ciprofloxacin AUD is related to the proportion of ESBL-producing E. coli two quarters later. In conclusion, excessive use of antibiotics was shown to affect the prevalence of resistant organisms in the future. Therefore, the control of antibiotics with antimicrobial stewardship programs should be considered to restrict antimicrobial resistance.

Antibiotic usage in hospitalized patients: a one-day point prevalence study

2020 ◽  
Vol 32 (4) ◽  
pp. 188-192
Author(s):  
Oguz Karabay ◽  
Nevin Ince ◽  
Adalet Aypak ◽  
Ertugrul Guclu ◽  
Hurrem Bodur ◽  
...  
Keyword(s):  
Antibiotic Usage ◽  
Hospitalized Patients ◽  
Point Prevalence ◽  
Prevalence Study ◽  
Point Prevalence Study
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