Abstract
Antimicrobial stewardship teams (ASTs) have been well-accepted in recent years; however, their clinical outcomes have not been fully investigated in urological patients. The purpose of this study was to evaluate the outcomes of intervention via a retrospective review of urological patients, as discussed in the AST meetings, who were treated with broad-spectrum antibiotics between 2014 and 2018 at the Department of Urology, Kobe University Hospital in Japan. Interventions were discussed in AST meetings for patients identified by pharmacists as having received inappropriate antibiotic therapy. The annual changes in numbers of inappropriate medications and culture submissions over five years at the urology department were statistically analyzed. Among 1,033 patients audited by pharmacists, inappropriate antibiotic therapy was found in 118 cases (11.4%). The numbers of inappropriate antibiotic use cases and of interventions for indefinite infections had significantly decreased during the study period (p = 0.012 and p = 0.033, respectively). However, the number of blood and drainage culture submissions had significantly increased (p = 0.009 and p = 0.035, respectively). Our findings suggest that urologists have probably become more familiar with infectious disease management through AST intervention, leading to a decrease in inappropriate antibiotic use and an increase in culture submissions.
Highlights
The main goal of antimicrobial stewardship (AS) is to decrease the incidence of antimicrobial resistance (AMR) [1]
In our Antimicrobial stewardship teams (ASTs) meetings, these patients were reviewed for the appropriateness of broad-spectrum antibiotic use, including antibiotic medication or whether cultures had to be obtained for antibiotic selection
infection control doctors (ICDs), the AST plays a major role in managing antimicrobial use to control infectious diseases due to AMR bacterial strains
Summary
The main goal of antimicrobial stewardship (AS) is to decrease the incidence of antimicrobial resistance (AMR) [1]. Healthcare professionals and even national governments have called for action to prevent the increase of AMR by the appropriate use of broad-spectrum antibiotics, such as carbapenems, Antibiotics 2020, 9, 63; doi:10.3390/antibiotics9020063 www.mdpi.com/journal/antibiotics. The AST consists of physicians, pharmacists, clinical microbiologists, and nurses specialized in infectious disease and antimicrobial agents [3]. They are often certified infection control specialists such as infection control doctors (ICDs). In the case of urinary tract infection (UTI), physicians often make late decisions to carry out drainage or use of invalid antibiotics that possibly generate resistance in bacteria. As urologists sometimes use invalid broad-spectrum antibiotics, collaboration among several professionals in ASTs is urgently needed. This study investigated patients, who were admitted and treated with broad-spectrum antibiotics in the urological ward, and compared the changes in the numbers of inappropriately prescribed medications and culture submissions over five years
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