Comparison between antimicrobial stewardship program and intervention by infection control team for managing antibiotic use in neurogenic bladder-related urinary tract infection patients: A retrospective chart audit - 25/05/22
, Young-Min Yang, MD b, Masashi Nomi, MD, PhD d, Akihiro Yanagiuchi, MD, PhD d, Shiuh-Bin Fang, MD, PhD e, f, Reo Onishi, BS c, Atsushi Sengoku, MD, PhD d, Masato Fujisawa, MD, PhD bHighlights |
• | This is the study to investigate the impact of antimicrobial stewardship program (ASP) interventions. |
• | ASP contributed to decrease antimicrobial use density and antimicrobial agent costs. |
• | ASP contributed to improve antimicrobial susceptibilities of E. coli and K. pneumoniae to several antibiotics, compared to ICT interventions. |
Abstract |
Background |
Antimicrobial prescriptions are relatively common in urologic outpatients. Therefore, it is necessary to investigate the impact of antimicrobial stewardship program (ASP) interventions.
Methods |
In urology outpatients, antimicrobial use density (AUD), antimicrobial agent costs, isolation of urinary tract infection (UTI)-causing organisms and their antimicrobial susceptibilities were compared between intervention by infection control team (ICT) era (pre-2014) and ASP era (post-2014) in 2739 patients with lower urinary tract symptoms, including neurogenic bladder patients with UTI or suspected UTI, from 2011 to 2020.
Results |
In the ASP, overall AUD (P<.001), cefotiam (CTM) (P=.0013), 2nd-generation cephalosporins (P=.026), cefdinir (CFDN) (P<.001), levofloxacin (LVFX) (P<.001), sitafloxacin (STFX) (P=.0016), and tosufloxacin (TFLX) (P=.0044) showed a significant decrease, but cefaclor (P=.019) showed a significant increase. Regarding antimicrobial agent costs, overall (P=.016), CTM (P=.021), 2nd-generation cephalosporins (P=.033), CFDN (P=.016), LVFX (P=.016), STFX (P=.033), and TFLX (P=.033) showed a significant decrease in the ASP. UTI-causing antimicrobial susceptibilities, CTM (P=.035), LVFX (P=.026) and sulfamethoxazole/trimethoprim (P=.048) in E. coli, and minocycline (P=.026) in K. pneumoniae showed a significant improve in the ASP.
Conclusion |
ASP contributed to decrease AUD and antimicrobial agent costs, and to improve antimicrobial susceptibilities of E. coli and K. pneumoniae to several antibiotics, compared to ICT. Further prospective studies are necessary for definitive conclusions.
Le texte complet de cet article est disponible en PDF.Key Words : ASP, Intervention by ICT, Neurogenic bladder patients, Urinary tract infection, Antibiotic resistance, Antibiotic consumption
Plan
| Funding: None to declare. |
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| Conflicts of Interest: All authors report no conflicts of interest. |
Vol 50 - N° 6
P. 668-672 - juin 2022 Retour au numéro
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