Abstract
Antibiotic stewardship programs optimize the use of antimicrobials to prevent the development of resistance and improve patient outcomes. In this prospective interventional study, a multidisciplinary team led by surgeons implemented a program aimed at shortening the duration of antibiotic treatment <7 days. The impact of the intervention on antibiotic consumption adjusted to bed-days and discharges, and the isolation of multiresistant bacteria (MRB) was also studied. Furthermore, the surgeons were surveyed regarding their beliefs and feelings about the program. Out of 1409 patients, 40.7% received antibiotic therapy. Treatment continued for over 7 days in 21.5% of cases, and, as can be expected, source control was achieved in only 48.8% of these cases. The recommendations were followed in 90.2% of cases, the most frequent being to withdraw the treatment (55.6%). During the first 16 months of the intervention, a sharp decrease in the percentage of extended treatments, with R2 = 0.111 was observed. The program was very well accepted by surgeons, and achieved a decrease in both the consumption of carbapenems and in the number of MRB isolations. Multidisciplinary stewardship teams led by surgeons seem to be well received and able to better manage antibiotic prescription in surgery.
Highlights
Introduction in published maps and institutionalAccording to the World Health Organization (WHO), antimicrobial resistance (AMR)is one of the biggest threats to global health, food security and development [1]
The most important reason that led to a prolonged antibiotic treatment was intraabdominal infection (80.5%)
Other authors found that in patients with complicated intraabdominal infections, a fixed short duration of antibiotic treatment resulted in similar outcomes to those based on resolution of physiological abnormalities [22,23]
Summary
According to the World Health Organization (WHO), antimicrobial resistance (AMR). Is one of the biggest threats to global health, food security and development [1]. The. World Health Assembly in 2015 endorsed a global action plan on AMR, one of its strategic objectives being to optimize the use of antimicrobial medicines [2]. The discovery of antibiotics transformed the practice of medicine in the modern world, making once lethal infections readily treatable and enabling many other medical advances, such as organ transplants and chemotherapy, possible. Initiation of antibiotics to treat sepsis and severe infections reduces morbidity and mortality [3]. The largest driver for the development and spread of AMR is the overuse and misuse of antibiotics [4].
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