The impact of earlier intervention by an antimicrobial stewardship team for specific antimicrobials in a single weekly intervention

•The effects of earlier intervention by an antimicrobial stewardship team (AST) for specific antimicrobials in a single weekly intervention were examined.•The timing of AST intervention shortened on average from 15.5 days to 4.2 days.•The AST intervention led to a reduction in antimicrobial use dens...

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Bibliographic Details
Published in:International journal of infectious diseases 2018-12, Vol.77, p.34-39
Main Authors: Hagiwara, D., Sato, K., Miyazaki, M., Kamada, M., Moriwaki, N., Nakano, T., Shiotsuka, S., Tokushige, C., Toh, H., Kamimura, H., Togawa, A., Takata, T.
Format: Article
Language:English
Subjects:
Anti-Infective Agents - economics
Anti-Infective Agents - therapeutic use
Antimicrobial resistance
Antimicrobial Stewardship
Antimicrobial stewardship program
Antimicrobial use density
Carbapenems - economics
Carbapenems - therapeutic use
Cost
Daptomycin - therapeutic use
Drug Resistance, Microbial
Fluoroquinolones - therapeutic use
Humans
Linezolid - therapeutic use
Methicillin-Resistant Staphylococcus aureus - drug effects
Piperacillin, Tazobactam Drug Combination - economics
Piperacillin, Tazobactam Drug Combination - therapeutic use
Pseudomonas aeruginosa
Pseudomonas aeruginosa - drug effects
Retrospective Studies
Teicoplanin - therapeutic use
Time Factors
Treatment Outcome
Vancomycin - therapeutic use
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Summary:•The effects of earlier intervention by an antimicrobial stewardship team (AST) for specific antimicrobials in a single weekly intervention were examined.•The timing of AST intervention shortened on average from 15.5 days to 4.2 days.•The AST intervention led to a reduction in antimicrobial use densities and the costs of the related antimicrobials.•The rates of carbapenem resistance in Pseudomonas aeruginosa showed a significant reduction.•The mortality rate and length of stay did not change during the study period. The objective of this study was to evaluate the effects of earlier intervention by an antimicrobial stewardship team (AST) on antimicrobial use, antimicrobial resistance rates, and the clinical outcomes, without changing the weekly intervention schedule. A retrospective study was conducted at Fukuoka University Hospital between April 2013 and March 2016. The effects were compared among three study periods (SP): SP1 (patients receiving anti-methicillin-resistant Staphylococcus aureus agents and carbapenems for ≥14 days), SP2 (patients receiving specific antimicrobials for ≥14 days), and SP3 (patients receiving specific antimicrobials regardless of the duration of treatment). The timing of AST intervention was shortened from an average of 15.5days after administration in SP1 to 4.2 days in SP3. The antimicrobial use density (AUD) of carbapenems and piperacillin–tazobactam decreased significantly (SP2 vs. SP3, p
ISSN:1201-9712
1878-3511
DOI:10.1016/j.ijid.2018.09.025