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Title: Antimicrobial stewardship in a Gastroenterology Department: Impact on antimicrobial consumption, antimicrobial resistance and clinical outcome
Authors: Bedini, Andrea
De Maria, Nicola
Del Buono, Mariagrazia
Bianchini, Marcello
Mancini, Mauro
Binda, Cecilia
Brasacchio, Andrea
Orlando, Gabriella
Franceschini, Erica
Meschiari, Marianna
Sartini, Alessandro
Zona, Stefano
Paioli, Serena
Villa, Erica
Mussini, Cristina
Issue Date: 2016
Source: DIGESTIVE AND LIVER DISEASE, 48(10), p. 1142-1147
Abstract: Background: A major cause of the increase in antimicrobial resistance is the inappropriate use of antimicrobials. Aims: To evaluate the impact on antimicrobial consumption and clinical outcome of an antimicrobial stewardship program in an Italian Gastroenterology Department. Methods: Between October 2014 and September 2015 (period B), a specialist in infectious diseases (ID) controlled all antimicrobial prescriptions and decided about the therapy in agreement with gastroenterologists. The defined daily doses of antimicrobials (DDDs), incidence of MDR-infections, mean length of stay and overall in-hospital mortality rate were compared with those of the same period in the previous 12-months (period A). Results: During period B, the ID specialist performed 304 consultations: antimicrobials were continued in 44.4% of the cases, discontinued in 13.8%, not recommended in 12.1%, de-escalated 9.9%, escalated in 7.9%, and started in 4.0%. Comparing the 2 periods, we observed a decreased of antibiotics consumption (from 109.81 to 78.45 DDDs/100 patient-days, p = 0.0005), antifungals (from 41.28 to 24.75 DDDs/100pd, p = 0.0004), carbapenems (from 15.99 to 6.80 DDDsx100pd, p = 0.0032), quinolones (from 35.79 to 17.82 DDDsx100pd, p = 0.0079). No differences were observed in incidence of MDR-infections, length of hospital stay (LOS), and mortality rate. Conclusions: ASP program had a positive impact on reducing the consumption of antimicrobials, without an increase in LOS and mortality.
Notes: [Bedini, Andrea; Brasacchio, Andrea; Orlando, Gabriella; Franceschini, Erica; Meschiari, Marianna; Zona, Stefano; Mussini, Cristina] Policlin Modena, Azienda Osped Univ, Clin Infect Dis, Modena, Italy. [De Maria, Nicola; Del Buono, Mariagrazia; Bianchini, Marcello; Binda, Cecilia; Sartini, Alessandro; Villa, Erica] Policlin Modena, Azienda Osped Univ, Gastroenterol Unit, Modena, Italy. [Mancini, Mauro; Paioli, Serena] Policlin Modena, Azienda Osped Univ, Dept Pharmaceut, Modena, Italy. [Gyssens, Inge C.] Hasselt Univ, Dept Infect Dis, Hasselt, Belgium.
Keywords: Antifungals; Antimicrobial stewardship; Carbapenems; Gastroenterology; MDR-microorganisms;antifungals; antimicrobial stewardship; carbapenems; gastroenterology; MDR-microorganisms
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ISSN: 1590-8658
e-ISSN: 1878-3562
DOI: 10.1016/j.dld.2016.06.023
ISI #: 000384017800006
Rights: (C) 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
Category: A1
Type: Journal Contribution
Validations: ecoom 2017
Appears in Collections:Research publications

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