Impact of sink removal from intensive care unit rooms on the consumption of antibiotics and on results of Zero Resistance Project

Abstract

IntroductionDue to the favourable impact of removing the sinks on isolations in bronchoaspirate samples of patients with mechanical ventilation, we now evaluate the impact on the consumption of antibiotics as well as on the results of the Zero Resistance Project (ZRP). Patients and methodsAll the patients admitted to the unit in a quasi-experimental before–after study with a pre-intervention period between 2014 and 2016 and a post-intervention period from 2016 to 2017, to evaluate antibiotic consumption in defined daily doses, and until 2018, to evaluate the ZRP indicators. The intervention was the removal of the sinks from the rooms of the ICU. We evaluated antibiotic consumption densities and their ratios, grouped as Enterobacteriaceae and non-fermenting gram-negative bacilli (NFGNB) according to their antibiograms; the absolute number of ‘antibiotic days’, ‘hospitalised days’, ‘isolation days’, and ‘multi-resistant bacteria (MRB) days’; as well as their incidence densities per 1000 hospitalised days and the ratio between the two years prior to and the two years after the intervention. ResultsPost-intervention antibiotic use was 1.61-fold (1.60–1.62) and 2.24-fold (2.10–2.37) lower for antibiotics used against Enterobacteriaceae and NFGNB, respectively. There were also reductions in the number of days of antibiotic use by 1.29-fold (1.22–1.36), number of MRB days by 1.84-fold (1.63–2.08), and number of patient isolation days by 1.51-fold (1.38–1.66). DiscussionThe results suggest that the intervention had a favourable impact on the consumption of antibiotics, as well as on the number of days on antibiotics, MRB, and isolation.