An Audit-Based, Infectious Disease Specialist-Guided Antimicrobial Stewardship Program Profoundly Reduced Antibiotic Use Without Negatively Affecting Patient Outcomes.
(2015) In Open Forum Infectious Diseases 2(2). p.042-042- Abstract
- Background. Antimicrobial stewardship programs are increasingly implemented in hospital care. They aim to simultaneously optimize outcomes for individual patients with infections and reduce financial and health-associated costs of overuse of antibiotics. Few studies have examined the effects of antimicrobial stewardship programs in settings with low proportions of antimicrobial resistance, such as in Sweden. Methods. An antimicrobial stewardship program was introduced during 5 months of 2013 in a department of internal medicine in southern Sweden. The intervention consisted of audits twice weekly on all patients given antibiotic treatment. The intervention period was compared with a historical control consisting of patients treated with... (More)
- Background. Antimicrobial stewardship programs are increasingly implemented in hospital care. They aim to simultaneously optimize outcomes for individual patients with infections and reduce financial and health-associated costs of overuse of antibiotics. Few studies have examined the effects of antimicrobial stewardship programs in settings with low proportions of antimicrobial resistance, such as in Sweden. Methods. An antimicrobial stewardship program was introduced during 5 months of 2013 in a department of internal medicine in southern Sweden. The intervention consisted of audits twice weekly on all patients given antibiotic treatment. The intervention period was compared with a historical control consisting of patients treated with antibiotics in the same wards in 2012. Studied outcome variables included 28-day mortality and readmission, length of hospital stay, and use of antibiotics. Results. A reduction of 27% in total antibiotic use (2387 days of any antibiotic) was observed in the intervention period compared with the control period. The reduction was due to fewer patients started on antibiotics as well as to significantly shorter durations of antibiotic courses (P < .001). An earlier switch to oral therapy and a specific reduction in use of third-generation cephalosporins and fluoroquinolones was also evident. Mortality, total readmissions, and lengths of stay in hospital were unchanged compared with the control period, whereas readmissions due to a nonresolved infection were fewer during the intervention of 2013. Conclusions. This study demonstrates that an infectious disease specialist-guided antimicrobial stewardship program can profoundly reduce antibiotic use in a low-resistance setting with no negative effect on patient outcome. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/8038921
- author
- Nilholm, Hannah ; Holmstrand, Linnea ; Ahl, Jonas LU ; Månsson, Fredrik LU ; Odenholt, Inga LU ; Tham, Johan LU ; Melander, Eva LU and Resman, Fredrik LU
- organization
- publishing date
- 2015
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Open Forum Infectious Diseases
- volume
- 2
- issue
- 2
- pages
- 042 - 042
- publisher
- Oxford University Press
- external identifiers
-
- pmid:26380341
- wos:000365786200037
- pmid:26380341
- scopus:84978328069
- ISSN
- 2328-8957
- DOI
- 10.1093/ofid/ofv042
- language
- English
- LU publication?
- yes
- id
- 9e49a2d6-4b57-476b-9f34-7e65b5e43cd5 (old id 8038921)
- alternative location
- http://www.ncbi.nlm.nih.gov/pubmed/26380341?dopt=Abstract
- date added to LUP
- 2016-04-01 14:38:11
- date last changed
- 2022-03-22 01:07:35
@article{9e49a2d6-4b57-476b-9f34-7e65b5e43cd5,
abstract = {{Background. Antimicrobial stewardship programs are increasingly implemented in hospital care. They aim to simultaneously optimize outcomes for individual patients with infections and reduce financial and health-associated costs of overuse of antibiotics. Few studies have examined the effects of antimicrobial stewardship programs in settings with low proportions of antimicrobial resistance, such as in Sweden. Methods. An antimicrobial stewardship program was introduced during 5 months of 2013 in a department of internal medicine in southern Sweden. The intervention consisted of audits twice weekly on all patients given antibiotic treatment. The intervention period was compared with a historical control consisting of patients treated with antibiotics in the same wards in 2012. Studied outcome variables included 28-day mortality and readmission, length of hospital stay, and use of antibiotics. Results. A reduction of 27% in total antibiotic use (2387 days of any antibiotic) was observed in the intervention period compared with the control period. The reduction was due to fewer patients started on antibiotics as well as to significantly shorter durations of antibiotic courses (P < .001). An earlier switch to oral therapy and a specific reduction in use of third-generation cephalosporins and fluoroquinolones was also evident. Mortality, total readmissions, and lengths of stay in hospital were unchanged compared with the control period, whereas readmissions due to a nonresolved infection were fewer during the intervention of 2013. Conclusions. This study demonstrates that an infectious disease specialist-guided antimicrobial stewardship program can profoundly reduce antibiotic use in a low-resistance setting with no negative effect on patient outcome.}},
author = {{Nilholm, Hannah and Holmstrand, Linnea and Ahl, Jonas and Månsson, Fredrik and Odenholt, Inga and Tham, Johan and Melander, Eva and Resman, Fredrik}},
issn = {{2328-8957}},
language = {{eng}},
number = {{2}},
pages = {{042--042}},
publisher = {{Oxford University Press}},
series = {{Open Forum Infectious Diseases}},
title = {{An Audit-Based, Infectious Disease Specialist-Guided Antimicrobial Stewardship Program Profoundly Reduced Antibiotic Use Without Negatively Affecting Patient Outcomes.}},
url = {{https://lup.lub.lu.se/search/files/4079648/8851990.pdf}},
doi = {{10.1093/ofid/ofv042}},
volume = {{2}},
year = {{2015}},
}