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- Title
The effectiveness of antimicrobial stewardship program implementation in a single university medical center.
- Authors
Jiyeon Bae; Namgi Park; Ji Yun Bae; Kang-Il Jun; Jeong-Han Kim; Chung-Jong Kim; Kyunghee Kim; Sun Ah Kim; Sandy Jeong Rhie; Hee Jung Choi
- Abstract
배경: Antimicrobial stewardship program (ASP) is essential in reducing antimicrobial resistance (AMR) and the length of hospital stay. Antibiotic dosage and/or administration time according to impaired renal function were recommended to inpatients who were on antibiotics therapy and either intermittent hemodialysis or continuous renal replacement therapy (CRRT) in Ewha Womans University Medical Center (EUMC) since May 2019. A retrospective study was conducted to compare the outcomes before and after this ASP implementation. 방법: ASP intervention cases in EUMC from May 2019 to April 2022 were included in intervention group. Control group consisted of inpatients who were on either hemodialysis or CRRT and received inappropriate antibiotic dosage from February 2018 to April 2019. One-to-one matching was performed on patients who received the same antibiotics considering age, type of hemodialysis, and Charlson Comorbidity Index. The outcome measures were the acquisition of Vancomycin-resistant Enterococcus (VRE), Carbapenem-resistant Acinetobacter baumannii (CRAB), and Carbapenem-resistant Enterobacteriaceae (CRE), the length of hospital stay, incidence rate of Clostridioides difficile infection, and in-hospital mortality rate. It was analyzed by either t-test or Chi-square test using R 4.0.2. 결과: The 122 cases out of the 570 intervention group were matched. VRE incidence rate decreased significantly from 22.1% in control group to 5.7% in intervention group (P <0.001). The incidence rate of CRAB showed no significant difference (P = 0.22) whereas that of CRE increased significantly (0.8% vs 6.6%, P = 0.04). The length of hospital stay showed significant decrease (P <0.001). However, there were no differences for the incidence rate of C.difficile infection (P = 0.06) and in-hospital mortality rate (P = 0.37). 결론: Implementation of ASP reduced the incidence of VRE and the length of hospital stay. The efficacy of the program should be assessed regularly.
- Subjects
ANTIMICROBIAL stewardship; ACADEMIC medical centers; CARBAPENEM-resistant bacteria; LENGTH of stay in hospitals; RENAL replacement therapy
- Publication
Infection & Chemotherapy, 2022, Vol 54, p268
- ISSN
2093-2340
- Publication type
Article