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An Audit-Based, Infectious Disease Specialist-Guided Antimicrobial Stewardship Program Profoundly Reduced Antibiotic Use Without Negatively Affecting Patient Outcomes.

Nilholm, Hannah; Holmstrand, Linnea; Ahl, Jonas LU ; Månsson, Fredrik LU ; Odenholt, Inga LU ; Tham, Johan LU ; Melander, Eva LU and Resman, Fredrik LU (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)
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author
organization
publishing date
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
  • 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
2015-10-03 19:40:14
date last changed
2017-10-29 04:03:08
@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 &lt; .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          = {http://dx.doi.org/10.1093/ofid/ofv042},
  volume       = {2},
  year         = {2015},
}