Impact of antimicrobial stewardship programme on hospitalized patients at the intensive care unit

a prospective audit and feedback study

Maher R. Khdour, Hussein O. Hallak, Mamoon A. Aldeyab, Mowaffaq A. Nasif, Aliaa M. Khalili, Ahamad A. Dallashi, Mohammad B. Khofash, Michael G. Scott

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Aims: Inappropriate use of antibiotics is one of the most important factors contributing to the emergence of drug resistant pathogens. The purpose of this study was to measure the clinical impact of antimicrobial stewardship programme (ASP) interventions on hospitalized patients at the Intensive care unit at Palestinian Medical Complex. Methods: A prospective audit with intervention and feedback by ASP team within 48–72 h of antibiotic administration began in September 2015. Four months of pre-ASP data were compared with 4 months of post-ASP data. Data collected included clinical and demographic data; use of antimicrobials measured by defined daily doses, duration of therapy, length of stay, readmission and all-cause mortality. Results: Overall, 176 interventions were made the ASP team with an average acceptance rate of 78.4%. The most accepted interventions were dose optimization (87.0%) followed by de-escalation based on culture results with an acceptance rate of 84.4%. ASP interventions significantly reduces antimicrobial use by 24.3% (87.3 defined daily doses/100 beds vs. 66.1 defined daily doses/100 beds P < 0.001). The median (interquartile range) of length of stay was significantly reduced post ASP [11 (3–21) vs. 7 (4–19) days; P < 0.01]. Also, the median (interquartile range) of duration of therapy was significantly reduced post-ASP [8 (5–12) days vs. 5 (3–9); P = 0.01]. There was no significant difference in overall 30-day mortality or readmission between the pre-ASP and post-ASP groups (26.9% vs. 23.9%; P = 0.1) and (26.1% vs. 24.6%; P = 0.54) respectively. Conclusions: Our prospective audit and feedback programme was associated with positive impact on antimicrobial use, duration of therapy and length of stay.

Original languageEnglish
Pages (from-to)708-715
Number of pages8
JournalBritish Journal of Clinical Pharmacology
Volume84
Issue number4
Early online date13 Dec 2017
DOIs
Publication statusPublished - Apr 2018
Externally publishedYes

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Intensive Care Units
Length of Stay
Anti-Bacterial Agents
Mortality
Therapeutics
Demography
Pharmaceutical Preparations

Cite this

Khdour, Maher R. ; Hallak, Hussein O. ; Aldeyab, Mamoon A. ; Nasif, Mowaffaq A. ; Khalili, Aliaa M. ; Dallashi, Ahamad A. ; Khofash, Mohammad B. ; Scott, Michael G. / Impact of antimicrobial stewardship programme on hospitalized patients at the intensive care unit : a prospective audit and feedback study. In: British Journal of Clinical Pharmacology. 2018 ; Vol. 84, No. 4. pp. 708-715.
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abstract = "Aims: Inappropriate use of antibiotics is one of the most important factors contributing to the emergence of drug resistant pathogens. The purpose of this study was to measure the clinical impact of antimicrobial stewardship programme (ASP) interventions on hospitalized patients at the Intensive care unit at Palestinian Medical Complex. Methods: A prospective audit with intervention and feedback by ASP team within 48–72 h of antibiotic administration began in September 2015. Four months of pre-ASP data were compared with 4 months of post-ASP data. Data collected included clinical and demographic data; use of antimicrobials measured by defined daily doses, duration of therapy, length of stay, readmission and all-cause mortality. Results: Overall, 176 interventions were made the ASP team with an average acceptance rate of 78.4{\%}. The most accepted interventions were dose optimization (87.0{\%}) followed by de-escalation based on culture results with an acceptance rate of 84.4{\%}. ASP interventions significantly reduces antimicrobial use by 24.3{\%} (87.3 defined daily doses/100 beds vs. 66.1 defined daily doses/100 beds P < 0.001). The median (interquartile range) of length of stay was significantly reduced post ASP [11 (3–21) vs. 7 (4–19) days; P < 0.01]. Also, the median (interquartile range) of duration of therapy was significantly reduced post-ASP [8 (5–12) days vs. 5 (3–9); P = 0.01]. There was no significant difference in overall 30-day mortality or readmission between the pre-ASP and post-ASP groups (26.9{\%} vs. 23.9{\%}; P = 0.1) and (26.1{\%} vs. 24.6{\%}; P = 0.54) respectively. Conclusions: Our prospective audit and feedback programme was associated with positive impact on antimicrobial use, duration of therapy and length of stay.",
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Impact of antimicrobial stewardship programme on hospitalized patients at the intensive care unit : a prospective audit and feedback study. / Khdour, Maher R.; Hallak, Hussein O.; Aldeyab, Mamoon A.; Nasif, Mowaffaq A.; Khalili, Aliaa M.; Dallashi, Ahamad A.; Khofash, Mohammad B.; Scott, Michael G.

In: British Journal of Clinical Pharmacology, Vol. 84, No. 4, 04.2018, p. 708-715.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Impact of antimicrobial stewardship programme on hospitalized patients at the intensive care unit

T2 - a prospective audit and feedback study

AU - Khdour, Maher R.

AU - Hallak, Hussein O.

AU - Aldeyab, Mamoon A.

AU - Nasif, Mowaffaq A.

AU - Khalili, Aliaa M.

AU - Dallashi, Ahamad A.

AU - Khofash, Mohammad B.

AU - Scott, Michael G.

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N2 - Aims: Inappropriate use of antibiotics is one of the most important factors contributing to the emergence of drug resistant pathogens. The purpose of this study was to measure the clinical impact of antimicrobial stewardship programme (ASP) interventions on hospitalized patients at the Intensive care unit at Palestinian Medical Complex. Methods: A prospective audit with intervention and feedback by ASP team within 48–72 h of antibiotic administration began in September 2015. Four months of pre-ASP data were compared with 4 months of post-ASP data. Data collected included clinical and demographic data; use of antimicrobials measured by defined daily doses, duration of therapy, length of stay, readmission and all-cause mortality. Results: Overall, 176 interventions were made the ASP team with an average acceptance rate of 78.4%. The most accepted interventions were dose optimization (87.0%) followed by de-escalation based on culture results with an acceptance rate of 84.4%. ASP interventions significantly reduces antimicrobial use by 24.3% (87.3 defined daily doses/100 beds vs. 66.1 defined daily doses/100 beds P < 0.001). The median (interquartile range) of length of stay was significantly reduced post ASP [11 (3–21) vs. 7 (4–19) days; P < 0.01]. Also, the median (interquartile range) of duration of therapy was significantly reduced post-ASP [8 (5–12) days vs. 5 (3–9); P = 0.01]. There was no significant difference in overall 30-day mortality or readmission between the pre-ASP and post-ASP groups (26.9% vs. 23.9%; P = 0.1) and (26.1% vs. 24.6%; P = 0.54) respectively. Conclusions: Our prospective audit and feedback programme was associated with positive impact on antimicrobial use, duration of therapy and length of stay.

AB - Aims: Inappropriate use of antibiotics is one of the most important factors contributing to the emergence of drug resistant pathogens. The purpose of this study was to measure the clinical impact of antimicrobial stewardship programme (ASP) interventions on hospitalized patients at the Intensive care unit at Palestinian Medical Complex. Methods: A prospective audit with intervention and feedback by ASP team within 48–72 h of antibiotic administration began in September 2015. Four months of pre-ASP data were compared with 4 months of post-ASP data. Data collected included clinical and demographic data; use of antimicrobials measured by defined daily doses, duration of therapy, length of stay, readmission and all-cause mortality. Results: Overall, 176 interventions were made the ASP team with an average acceptance rate of 78.4%. The most accepted interventions were dose optimization (87.0%) followed by de-escalation based on culture results with an acceptance rate of 84.4%. ASP interventions significantly reduces antimicrobial use by 24.3% (87.3 defined daily doses/100 beds vs. 66.1 defined daily doses/100 beds P < 0.001). The median (interquartile range) of length of stay was significantly reduced post ASP [11 (3–21) vs. 7 (4–19) days; P < 0.01]. Also, the median (interquartile range) of duration of therapy was significantly reduced post-ASP [8 (5–12) days vs. 5 (3–9); P = 0.01]. There was no significant difference in overall 30-day mortality or readmission between the pre-ASP and post-ASP groups (26.9% vs. 23.9%; P = 0.1) and (26.1% vs. 24.6%; P = 0.54) respectively. Conclusions: Our prospective audit and feedback programme was associated with positive impact on antimicrobial use, duration of therapy and length of stay.

KW - antibiotic use

KW - antimicrobials

KW - intensive care unit

KW - stewardship

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