Impact of the Antimicrobial Stewardship Team Intervention Focusing on Changes in Prescribing Trends and the Rate of Carbapenem-resistant <i>P. aeruginosa</i>

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  • Naito Yuika
    Department of Hospital Pharmaceutics, Showa University School of Pharmacy Department of Infection Prevention and Control, Showa University Hospital Department of Pharmacy, Showa University Hospital
  • Maeda Masayuki
    Department of Infection Prevention and Control, Showa University Hospital Division of Infection Control Sciences, Department of Clinical Pharmacy, Showa University School of Pharmacy
  • Nagatomo Yasuhiro
    Department of Infection Prevention and Control, Showa University Hospital Division of Infection Diseases, Department of Medicine, Showa University School of Medicine
  • Ugajin Kazuhisa
    Department of Infection Prevention and Control, Showa University Hospital Department of Clinical Pathology Laboratory, Showa University Hospital
  • Akima Etsuko
    Department of Infection Prevention and Control, Showa University Hospital
  • Tanaka Michiko
    Department of Hospital Pharmaceutics, Showa University School of Pharmacy
  • Tokimatsu Issei
    Department of Infection Prevention and Control, Showa University Hospital Division of Infection Diseases, Department of Medicine, Showa University School of Medicine
  • Sasaki Tadanori
    Department of Pharmacy, Showa University Hospital

Bibliographic Information

Other Title
  • 抗菌薬適正使用支援チームのカルバペネム系薬適正使用ラウンドによる処方動向の変化と緑膿菌耐性率への影響に関する検討
  • コウキンヤク テキセイ シヨウ シエン チーム ノ カルバペネムケイヤク テキセイ シヨウ ラウンド ニ ヨル ショホウ ドウコウ ノ ヘンカ ト リョクノウキン タイセイリツ エ ノ エイキョウ ニ カンスル ケントウ
  • Impact of the antimicrobial stewardship team intervention focusing on changes in prescribing trends and the rate of carbapenem-resistant P. aeruginosa

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Abstract

<p>Antimicrobial stewardship (AS) intervention strategy is a critical process in promoting appropriate antibiotic use, thus preventing unnecessarily prolonged therapy and reducing antimicrobial resistance (AMR). Although limiting unnecessary carbapenem use by AS intervention is speculated to reduce AMR, there is a lack of specific data on the efficacy of AS team (AST) intervention regarding carbapenem-resistant Pseudomonas aeruginosa (CRPA). Consequently, this study aimed to evaluate the impact of our AS strategy on carbapenem use and CRPA. The AS intervention strategy was launched in July 2017 and consisted of daily audits and feedback on carbapenem use. We evaluated the 4-year prescription trend, including the rate of switching to other antimicrobials, and the rate of CRPA and the days of therapy required prior to and after the beginning of the AST intervention. The rate of switching to narrow-spectrum antibiotics and the discontinuation of carbapenem treatment were significantly higher in the pre-intervention period compared with the post-intervention period. (7.0% vs. 14.5%; p<0.001; 54.1% vs. 50.9%; p=0.027). However, there were no significant differences in the rate of CRPA prior to and after the beginning of the AST intervention. Furthermore, there was no correlation found between consumption and resistance rate (Pearson's r=0.123). Our results suggest that it is extremely important for AST to promote de-escalation and reduce unnecessary use, while the combination of process and outcome indicators other than antimicrobial consumption and resistance rate are required for the evaluation of the AS programs.</p>

Journal

  • YAKUGAKU ZASSHI

    YAKUGAKU ZASSHI 142 (5), 527-534, 2022-05-01

    The Pharmaceutical Society of Japan

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