The role of a DEdicated Infectious Disease consultant within an antimicrobial stewardship programme towards better patient CARE (DE-IDCARE Project): results from a quasi-experimental, single-centre study

IF 3.1 3区医学 Q1 INFECTIOUS DISEASES

Journal of Hospital Infection Pub Date : 2026-02-01 Epub Date: 2025-11-08 DOI:10.1016/j.jhin.2025.10.029

A. Oliva , C. Leanza , L. Martellone , S. Covino , C. Franchi , F. Cancelli , M. Carnevalini , V. Coradini , G. Magni , A. Coppola , M. Augurusa , G. Polito , A. Mingoli , F. Pugliese , C.M. Mastroianni

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引用次数: 0

Abstract

Background

The DE-IDCARE project aimed to evaluate the impact of dedicated infectious disease consultations (CIDs) compared with traditional on-demand ID consultations (CODs) within a structured antimicrobial stewardship programme (ASP).

Methods

A quasi-experimental, single-centre study included hospitalized patients in two high-risk settings (Emergency Surgery (ES) and post-neurosurgery intensive care units (NS-ICU)) receiving antimicrobial therapy during April–June 2023 (COD, pre-intervention, N = 117) and April–June 2024 (CID, post-intervention, N = 172). The CID model introduced tri-weekly systematic evaluations of all patients receiving antimicrobials. The intervention was assessed through 12 antimicrobial stewardship (AMS) indicators categorized into ID stewardship (ID-S), diagnostic stewardship (D-S) and therapeutic stewardship (T-S) and classified into optimal, nearly optimal, neutral, suboptimal and not optimal according to the difference in percentage between CID and COD. Antimicrobial consumption was analysed using the AWaRe classification and the DDD/100 days of hospitalization. New onset of multi-drug resistant (MDR) colonization as well as clinical outcomes were also evaluated.

Results

CID led to significant improvements in the majority of AMS indicators, especially antimicrobial discontinuation in cases without infection (+46%), 48–72 h re-evaluation of antimicrobial therapy (+36%) and appropriate duration of treatment (+21.1%). The use of Watch and Reserve antibiotics was reduced. New onset of MDR colonization was also reduced, while clinical outcomes were similar to COD.

Conclusion

The DE-IDCARE project underscores the potential of dedicated CIDs within a structured ASP, leading to optimization of antimicrobial prescriptions without significantly affecting patients' outcomes. These findings offer a strong rationale for the wider implementation of CID as a cornerstone of effective AMS strategies.

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抗菌药物管理项目（DE-IDCARE项目）中专门传染病顾问的作用：准实验性单中心研究的结果

背景：DE-IDCARE项目旨在评估在结构化抗菌药物管理计划（ASP）中，与传统的按需传染病咨询（COD）相比，专用传染病咨询（CID）的影响。材料和方法：一项准实验、单中心研究纳入了2023年4月至6月（COD，干预前，n=117）和2024年4月至6月（CID，干预后，n=172）在两个高危环境（急诊外科- es -和神经外科后重症监护病房- NS-ICU）接受抗菌治疗的住院患者。CID模型引入了对所有接受抗微生物药物治疗的患者每三周一次的系统评估。通过12项抗菌药物管理（AMS）指标对干预进行评估，这些指标分为ID管理（ID- s）、诊断管理（D-S）和治疗管理（T-S），并根据CID和COD之间的百分比差异分为最佳、接近最佳、中性、次优和非最佳。采用AWaRe分类和DDD/100天住院天数分析抗菌药物用量。多药耐药（MDR）定植的新发病以及临床结果也进行了评估。结果：CID导致大多数AMS指标显著改善，特别是无感染病例停药（+46%），48-72小时重新评估抗菌药物治疗（+36%）和治疗持续时间（+21.1%）。减少了Watch和Reserve抗生素的使用。耐多药定殖的新发病例也减少了，而临床结果与COD相似。结论：DE-IDCARE项目强调了在结构化ASP中进行专门的ID咨询的潜力，从而在不显著影响患者预后的情况下优化抗菌药物处方。这些发现为更广泛地实施CID作为有效AMS战略的基石提供了强有力的理由。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Hospital Infection 医学-传染病学

CiteScore

12.70

自引率

5.80%

发文量

271

审稿时长

19 days

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.