Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
6117801 | International Journal of Antimicrobial Agents | 2015 | 6 Pages |
Abstract
Antimicrobial stewardship has been shown to reduce unnecessary antibiotic use, but there are few data on the long-term benefits of such a programme. Antimicrobial use over a 13-year period since implementing an antimicrobial stewardship programme (ASP) at our institution was examined. Nosocomial rates of Clostridium difficile infection (CDI) and antimicrobial susceptibility patterns of common nosocomial micro-organisms over the same period were also reviewed. Total antimicrobial use decreased by 62.8% (PÂ <Â 0.0001). There were decreases in use of aminoglycosides (â91.3%; PÂ <Â 0.0001), cephalosporins (â68.3%; PÂ <Â 0.0001), extended-spectrum penicillins (â77.7%; PÂ <Â 0.0001), macrolides (â27.2%; PÂ =Â 0.002), clindamycin (â95.9%; PÂ <Â 0.0001) and quinolones (â78.7%; PÂ <Â 0.0001). Antifungal use decreased by 71.0% (PÂ <Â 0.0001). There were increases in the use of carbapenems (+736%, PÂ <Â 0.0001) and anti-MRSA drugs (+73.3%; PÂ <Â 0.0001). There was a 56.7% (PÂ =Â 0.007) reduction in nosocomial MRSA infections. Nosocomial CDI rates decreased by 42.6% (PÂ =Â 0.005) between 2003 and 2010 and then increased to near baseline levels following implementation of more sensitive testing for detection of CDI in 2011. There were decreases in the rate (â71.9%; PÂ =Â 0.001) and percentage (â51.4%; PÂ <Â 0.0001) of quinolone-resistant Pseudomonas aeruginosa. There were decreases in the rate (PÂ <Â 0.0001) and percentage (PÂ =Â 0.02) of carbapenem-resistant P. aeruginosa following implementation of a policy restricting ciprofloxacin use. We have demonstrated sustained reductions in both antimicrobial use and drug-resistant organisms following implementation of an ASP.
Keywords
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Authors
Paul P. Cook, Michael Gooch,