Short-term effects of antimicrobial stewardship programs on antibiotics usage, clinical outcomes, and multidrug resistant organisms in the post COVID-19 era.
J Infect Public Health
; 17(5): 819-824, 2024 May.
Article
em En
| MEDLINE
| ID: mdl-38537576
ABSTRACT
BACKGROUND:
Antimicrobial resistance is associated with increasing mortality rates and the emergence of multidrug-resistant (MDR) organisms. There is scarcity of data on the short-term impact of Antimicrobial Stewardship Programs (ASP) on antibiotic usage, clinical outcome and MDR organisms' pattern following the COVID-19 pandemic. This study evaluated the short-term effects of ASP on antibiotic usage, clinical outcomes and MDR organisms' pattern in the post COVID-19 era.METHODS:
Conducted at a tertiary academic health center, this observational study involved adult patients (≥18 years) in the general medical unit, treated with oral or intravenous antibiotics from May 1, 2021, to April 30, 2022. The applied ASP strategy was a prospective audit and feedback where a weekly meeting was held to discuss the antimicrobial therapy of admitted patient, after which recommendations were made regarding antimicrobial use.RESULTS:
The study included 301 patients with 166 (55.1%) pre-ASP and 135 (44.9%) post-ASP. The median (IQR) age was 69 (55-77) years with 56.1% were female. Antibiotic usage dropped by 25.2% post-ASP. The length of hospital stay (LOS) was longer post-ASP (7 days vs. 7.9 days, p = 0.001), with MDR infections being a significant predictor (OR 0.486, p < 0.001). There were no significant differences in 28-day readmission, recurrence of infections and all-cause mortality. Post-ASP, MDR pathogens increased (17.0% vs. 6.6%, p = 0.013), however, after separating post-ASP into two three-months periods, MDROs numbers decreased slightly (13 vs. 10).CONCLUSION:
Short-term ASP implementation post COVID-19 reduced antibiotic usage while other clinical outcomes remained unchanged. Nonetheless an increase in MDR pathogens and LOS was observed. Further research is required to assess ASP's long-term impact on MDR infections rates and specific patient group outcomes.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Contexto em Saúde:
4_TD
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6_ODS3_enfermedades_notrasmisibles
Problema de saúde:
4_antimicrobial_resistance
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4_covid_19
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4_pneumonia
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6_other_respiratory_diseases
Assunto principal:
Gestão de Antimicrobianos
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COVID-19
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Anti-Infecciosos
Limite:
Adult
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Aged
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Female
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Humans
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Male
Idioma:
En
Revista:
J Infect Public Health
/
J. infect. public health
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Journal infection and public health
Assunto da revista:
DOENCAS TRANSMISSIVEIS
/
SAUDE PUBLICA
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Omã