C Liberati, G Brigadoi, E Gres, E Barbieri, F Cavagnero, L Maestri, S Trivellato, A Zenere, M De Pieri, C Di Chiara, D Mengato, F Venturini, E De Canale, C Del Vecchio, A Tessari, A Tosoni, C Zaggia, C Contessa, C Giaquinto, E Carrara, E Tacconelli, A Amigoni, D Donà
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引用次数: 0
Abstract
Background: Patients admitted to the Paediatric Intensive Care Unit (PICU) constitute a high-risk group with a heightened likelihood of receiving inappropriate antimicrobial prescriptions. This study describes an Antimicrobial Stewardship Programme (ASP) in the PICU of a tertiary hospital in Italy.
Method: A pre-post quasi experimental study was conducted between 01/01/2019 and 31/12/2022 in the PICU of the Department for Women's and Children's Health, University Hospital of Padua. The ASP intervention started in February 2021 by a multidisciplinary team using the "handshake" approach. The population included all patients admitted to the PICU. The primary outcome was antibiotic consumption measured as days of therapy administered (DOTs)/1000 patient-days. An interrupted time series analysis was used to assess the trend in antibiotic prescribing before and after the intervention.
Results: 616 patients (episodes) were admitted in the pre-intervention phase (Jan 2019 - Jan 2021) and 602 patients in the post-intervention phase (Feb 2021 - Dec 2022). For overall antibiotic consumption, the ASP implementation resulted in a significant monthly decrease of 3.0% (p< 0.0001). Monthly reductions for higher consumption antibiotics were: meropenem 4.9% (p=0.009), glycopeptides 3.8% (p=0.014), piperacillin-tazobactam 4.8% (p=0.034). The consumption of third-generation cephalosporins and amikacin did not significantly vary.
Conclusions: The ASP intervention was effective in reducing the consumption of antimicrobials in such a complex setting. These results show the importance of antimicrobial stewardship in the scenario of critically ill children.
期刊介绍：
The Journal of Hospital Infection is the editorially independent scientific publication of the Healthcare Infection Society. The aim of the Journal is to publish high quality research and information relating to infection prevention and control that is relevant to an international audience.
The Journal welcomes submissions that relate to all aspects of infection prevention and control in healthcare settings. This includes submissions that:
provide new insight into the epidemiology, surveillance, or prevention and control of healthcare-associated infections and antimicrobial resistance in healthcare settings;
provide new insight into cleaning, disinfection and decontamination;
provide new insight into the design of healthcare premises;
describe novel aspects of outbreaks of infection;
throw light on techniques for effective antimicrobial stewardship;
describe novel techniques (laboratory-based or point of care) for the detection of infection or antimicrobial resistance in the healthcare setting, particularly if these can be used to facilitate infection prevention and control;
improve understanding of the motivations of safe healthcare behaviour, or describe techniques for achieving behavioural and cultural change;
improve understanding of the use of IT systems in infection surveillance and prevention and control.
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