Staphylococcus aureus - selective reporting of antibiogram results and its impact on antibiotic use: Interventional study with a reference group on the effect of switching from non-selective to selective antibiotic reporting

• Published in: Antimicrobial resistance & infection control 2021-11, Vol.10 (1), p.157-157, Article 157
• Main Authors: Lestin-Bernstein, Franka, Harberg, Ramona, Schumacher, Ingo, Briedigkeit, Lutz, Heese, Oliver, Biedermann, Kristina
• Format: Article
• Language: English
• Subjects: Aged; Anti-Bacterial Agents - administration & dosage; Anti-Bacterial Agents - pharmacology; Anti-Bacterial Agents - therapeutic use; Antibiotics; Antimicrobial stewardship (AMS); Antimicrobial Stewardship - methods; Beta lactamases; Clinics; Days of therapy (DOT); Disease control; Disease susceptibility; Drug resistance; Electronic Health Records; Female; Germany; Hospitals; Humans; International standards; Intervention; Laboratories; Male; Methicillin; Microbial Sensitivity Tests; Patients; Recommended daily dose (RDD); Selective antibiogram; Selective reporting of susceptibility testing; Staphylococcal Infections - drug therapy; Staphylococcus aureus; Staphylococcus aureus - drug effects; Staphylococcus aureus infection; Staphylococcus aureus infections; Staphylococcus infections; Statistical analysis; Tertiary Care Centers; Time Factors
• ISSN: 2047-2994; 2047-2994
• DOI: 10.1186/s13756-021-01021-7

Antimicrobial stewardship (AMS) strategies worldwide focus on optimising the use of antibiotics. Selective susceptibility reporting is recommended as an effective AMS tool although there is a lack of representative studies investigating the impact of selective susceptibility reporting on antibiotic use. The aim of this study was to investigate the impact of selective susceptibility reporting of Staphylococcus aureus (S. aureus) on antibiotic consumption. Enhancing the use of narrow-spectrum beta-lactam antibiotics such as flucloxacillin/cefazolin/cefalexin is one of the main goals in optimising antibiotic therapy of S. aureus infections. This interventional study with control group was conducted at a tertiary care hospital in Germany. During the one-year interventional period susceptibility reports for all methicillin-sensitive S. aureus (MSSA) were restricted to flucloxacillin/cefazolin/cefalexin, trimethoprim-sulfamethoxazole, clindamycin, gentamicin and rifampin/fosfomycin, instead of reporting all tested antibiotics. The impact of implementing selective reporting was analysed by monitoring total monthly antibiotic consumption in our hospital and in a reference hospital (recommended daily dose/100 occupied bed days: RDD/100 BD), as well as on an individual patient level by analysing days of therapy adjusted for bed days (DOT/ 100 BD) for patients with S. aureus bacteremia (SAB) and respectively skin and soft tissue infections (SSTI). MSSA-antibiograms were acquired for 2836 patients. The total use of narrow-spectrum beta-lactams more than doubled after implementing selective reporting (from 1.2 to 2.8 RDD/100 BD, P