Implementation of an antimicrobial stewardship program in Alexandria University Children's Hospital: an interventional study.

IF 3.5 3区 医学 Q1 PEDIATRICS
Sarah Elsayed Saad Refaei, Laila El-Attar, Amira Ezzat Khamis Amine, Marwa Ahmed Meheissen, Eman Hamza Hassan
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引用次数: 0

Abstract

Background: Antimicrobial resistance (AMR) represents a threat to global public health. The antibiotics' effectiveness against a variety of infections consequently has been declined with increasing morbidity, mortality, and treatment failure. To combat this, the implementation of Antimicrobial Stewardship Programs (ASPs) is essential for slowing the spread of resistant pathogens.

Aim of the work: The current study aimed to assess the outcomes following implementation of Antimicrobial Stewardship Program (ASP) at Alexandria University Children's Hospital.

Method: The study was conducted over nine months in a general pediatric ward. First, the medical records and microbiological reports were reviewed to establish tailored antibiotic guidelines. During the intervention phase, the ASP focused on prospective audits and physicians' education. The program's impact was evaluated through several key metrics: adherence to the guidelines, patient outcome (mortality rate and length of stay) and antibiotic consumption (expenditure, days of therapy, and treatment duration). All statistical analyses were conducted using IBM SPSS version 20.0.

Results: 219 patients in the preintervention phase were compared to 214 patients (post-intervention). Following ASP, the use of single antibiotics increased in post-intervention (69.6% versus 26%). During the study period, 70 interventions were required with a high acceptance rate (59%). The mean length of hospital stays decreased [10.80 (3-26) versus 12.89 (4-33) days], and both DOT/1000 patients and the average cost of antibiotics decreased (27.82% and 44.94%, respectively). Following ASP, the use of Tigecycline (-100%), Meropenem (-57.79%), and Vancomycin (-46.35%) reduced with an increase in the use of Cefotaxime (80.43%), Ceftriaxone (20.27%), and Ceftazidime (62.87%).

Conclusion: The implementation of institutional guidelines along with Prospective Audit and Feedback (PAF) was associated with improvements in antibiotic utilization, particularly in the resource-limited settings.

Clinical trial number: Not applicable.

亚历山大大学儿童医院抗菌药物管理项目的实施:一项介入性研究。
背景:抗菌素耐药性(AMR)是对全球公共卫生的威胁。抗生素对各种感染的有效性因此随着发病率、死亡率和治疗失败的增加而下降。为解决这一问题,实施抗微生物药物管理规划(asp)对于减缓耐药病原体的传播至关重要。工作目的:本研究旨在评估在亚历山大大学儿童医院实施抗菌药物管理计划(ASP)后的结果。方法:该研究在普通儿科病房进行了9个月。首先,对医疗记录和微生物报告进行了审查,以建立量身定制的抗生素指南。在干预阶段,ASP侧重于前瞻性审计和医生教育。该计划的影响是通过几个关键指标来评估的:对指南的遵守情况、患者结果(死亡率和住院时间)和抗生素消耗(支出、治疗天数和治疗时间)。所有统计分析均采用IBM SPSS 20.0版本进行。结果:干预前219例患者与干预后214例患者进行比较。ASP后,干预后单一抗生素的使用增加(69.6%对26%)。在研究期间,共实施了70项干预措施,接受率较高(59%)。平均住院时间缩短[10.80(3-26)天和12.89(4-33)天],DOT/1000患者和抗生素平均费用均下降(分别为27.82%和44.94%)。ASP后,替加环素(-100%)、美罗培南(-57.79%)和万古霉素(-46.35%)的使用率降低,头孢噻肟(80.43%)、头孢曲松(20.27%)和头孢他啶(62.87%)的使用率增加。结论:机构指南以及前瞻性审计和反馈(PAF)的实施与抗生素使用的改善有关,特别是在资源有限的环境中。临床试验号:不适用。
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
CiteScore
6.10
自引率
13.90%
发文量
192
审稿时长
6-12 weeks
期刊介绍: Italian Journal of Pediatrics is an open access peer-reviewed journal that includes all aspects of pediatric medicine. The journal also covers health service and public health research that addresses primary care issues. The journal provides a high-quality forum for pediatricians and other healthcare professionals to report and discuss up-to-the-minute research and expert reviews in the field of pediatric medicine. The journal will continue to develop the range of articles published to enable this invaluable resource to stay at the forefront of the field. Italian Journal of Pediatrics, which commenced in 1975 as Rivista Italiana di Pediatria, provides a high-quality forum for pediatricians and other healthcare professionals to report and discuss up-to-the-minute research and expert reviews in the field of pediatric medicine. The journal will continue to develop the range of articles published to enable this invaluable resource to stay at the forefront of the field.
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