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Title: | Long-Term Effects of a Stepwise, Multimodal, Non-Restrictive Antimicrobial Stewardship Programme for Reducing Broad-Spectrum Antibiotic Use in the ICU |
Author: | Ronda, Mar Gumucio Sanguino, Víctor D. Shaw, Evelyn Granada, Rosa Tubau, Fe Santafosta, Eva Sabater, Joan Esteve, Francisco Tebé, Cristian Mañez, Rafael Carratalà, Jordi Puig Asensio, Mireia Cobo Sacristán, Sara Padullés, Ariadna |
Keywords: | Antibiòtics Unitats de cures intensives Administració de medicaments Antibiotics Intensive care units Administration of drugs |
Issue Date: | 29-Jan-2024 |
Publisher: | MDPI AG |
Abstract: | Information on the long-term effects of non-restrictive antimicrobial stewardship (AMS) strategies is scarce. We assessed the effect of a stepwise, multimodal, non-restrictive AMS programme on broad-spectrum antibiotic use in the intensive care unit (ICU) over an 8-year period. Components of the AMS were progressively implemented. Appropriateness of antibiotic prescribing was also assessed by monthly point-prevalence surveys from 2013 onwards. A Poisson regression model was fitted to evaluate trends in the reduction of antibiotic use and in the appropriateness of their prescription. From 2011 to 2019, a total of 12,466 patients were admitted to the ICU. Antibiotic use fell from 185.4 to 141.9 DDD per 100 PD [absolute difference, -43.5 (23%), 95% CI -100.73 to 13.73; p = 0.13] and broad-spectrum antibiotic fell from 41.2 to 36.5 [absolute difference, -4.7 (11%), 95% CI -19.58 to 10.18; p = 0.5]. Appropriateness of antibiotic prescribing rose by 11% per year [IRR: 0.89, 95% CI 0.80 to 1.00; p = 0.048], while broad-spectrum antibiotic use showed a dual trend, rising by 22% until 2015 and then falling by 10% per year since 2016 [IRR: 0.90, 95% CI 0.81 to 0.99; p = 0.03]. This stepwise, multimodal, non-restrictive AMS achieved a sustained reduction in broad-spectrum antibiotic use in the ICU and significantly improved appropriateness of antibiotic prescribing. |
Note: | Reproducció del document publicat a: https://doi.org/10.3390/antibiotics13020132 |
It is part of: | Antibiotics, 2024, vol. 13, num. 2 |
URI: | http://hdl.handle.net/2445/209565 |
Related resource: | https://doi.org/10.3390/antibiotics13020132 |
ISSN: | 2079-6382 |
Appears in Collections: | Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL)) |
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antibiotics-13-00132-v2.pdf | 2.43 MB | Adobe PDF | View/Open |
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