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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 GYSSENS, Inge Mussini, Cristina |
Issue Date: | 2016 | Publisher: | ELSEVIER SCIENCE INC | 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 | Document URI: | http://hdl.handle.net/1942/22712 | 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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bedini 1.pdf Restricted Access | Published version | 624.56 kB | Adobe PDF | View/Open Request a copy |
antimicrobial.pdf | Peer-reviewed author version | 371.78 kB | Adobe PDF | View/Open |
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