Abstract
Antimicrobial stewardship programs (ASP) are an essential strategy to combat antimicrobial resistance. This study aimed to measure the impact of an ASP multidisciplinary team (MDT) escalating intervention on improvement of clinical, microbiological, and other measured outcomes in hospitalised adult patients from medical, intensive care, and burns units. The escalating intervention reviewed the patients’ cases in the intervention group through the clinical pharmacists in the wards and escalated complex cases to ID clinical pharmacist and ID physicians when needed, while only special cases required direct infectious disease (ID) physicians review. Both non-intervention and intervention groups were each followed up for six months. The study involved a total of 3000 patients, with 1340 (45%) representing the intervention group who received a total of 5669 interventions. In the intervention group, a significant reduction in length of hospital stay (p < 0.01), readmission (p < 0.01), and mortality rates (p < 0.01) was observed. Antibiotic use of the WHO AWaRe Reserve group decreased in the intervention group (relative rate change = 0.88). Intravenous to oral antibiotic ratio in the medical ward decreased from 4.8 to 4.1. The presented ASP MDT intervention, utilizing an escalating approach, successfully improved several clinical and other measured outcomes, demonstrating the significant contribution of clinical pharmacists atimproving antibiotic use and informing antimicrobial stewardship.
Highlights
This study aimed to evaluate the impact of an antimicrobial stewardship program multidisciplinary team (ASP MDT) intervention on clinical, microbiological, and other relevant measured outcomes among hospitalised patients
The study involved a total of 3000 patients from medical, intensive care, and burns units, with 1660 (55%) patients composing the non-intervention group and 1340 (45%) the intervention group
The multidisciplinary team, which represents the hospital antimicrobial stewardship program, used an escalating approach by reviewing all adult patients admitted to medical, intensive care, and burns units who are on antibiotic therapy
Summary
Antibiotics are undoubtedly among the most vital discoveries in human history, and their use has saved multitudinous lives from once-lethal infections [1]. The inappropriate use and overuse of antibiotics have played a role in the development of antimicrobial resistance [1,2,3,4]. Together with the lack of synthesis of new antibiotics, this poses significant challenges to worldwide health care, causing morbidity and increased costs of therapy and days of treatment [5,6,7,8]. Multidrug-resistant bacteria have increased hospital stays in the United States to around 8 million, with a cost of more than USD 20 billion [9]
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