ArticleThe Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious Diseases
Effects of a bundled Antimicrobial Stewardship Program on mortality: a cohort study.
Article in The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious Diseases. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Value of hospital antimicrobial stewardship programs [ASPs]: a systematic review.Antimicrobial resistance and infection control · 2019Pooled it
- Clinical impact of multidisciplinary carbapenem stewardship interventions: a retrospective cohort study.Journal of pharmaceutical policy and practice · 2023Article
- The impact of antimicrobial stewardship program designed to shorten antibiotics use on the incidence of resistant bacterial infections and mortality.Scientific reports · 2022Article
- Strategies to Improve Antimicrobial Utilization with a Special Focus on Developing Countries.Life (Basel, Switzerland) · 2021Review
- Day 10 Post-Prescription Audit Optimizes Antibiotic Therapy in Patients with Bloodstream Infections.Antibiotics (Basel, Switzerland) · 2020Article
- Sustainable implementation of antibiotic stewardship on a surgical intensive care unit evaluated over a 10-year period.Infection · 2020Observational
- Half of Prescribed Antibiotics Are Not Needed: A Pharmacist-Led Antimicrobial Stewardship Intervention and Clinical Outcomes in a Referral Hospital in Ethiopia.Frontiers in public health · 2020Article
- Assessment of Implementation of Antimicrobial Resistance Surveillance and Antimicrobial Stewardship Programs in Tanzanian Health Facilities a Year After Launch of the National Action Plan.Frontiers in public health · 2020Article
- Intravenous-to-oral antibiotic switch therapy: a cross-sectional study in critical care units.BMC infectious diseases · 2019Article
- The Use of Bloodstream Infection Mortality to Measure the Impact of Antimicrobial Stewardship Interventions: Assessing the Evidence.Infectious disease reports · 2017Review
- A Review of Quality Measures for Assessing the Impact of Antimicrobial Stewardship Programs in Hospitals.Antibiotics (Basel, Switzerland) · 2016Review
- A Narrative Review of Antimicrobial Stewardship Interventions within In-patient Settings and Resultant Patient Outcomes.Journal of pharmacy & bioallied sciencesReview
- A cost-effectiveness analysis of two different antimicrobial stewardship programs.The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious DiseasesArticle
- Article
- A broad-spectrum beta-lactam-sparing stewardship program in a middle-income country public hospital: antibiotic use and expenditure outcomes and antimicrobial susceptibility profiles.The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious DiseasesArticle
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3 authors.
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Abstract
objectivesTo assess a bundled Antimicrobial Stewardship Program and its effect on mortality. DATA: Eight months of clinical electronic medical records and Antimicrobial Stewardship Program registries were used as source of data.
methodThis is a historical cohort study conducted in a Brazilian University Hospital. Eligible patients were admitted to general wards or intensive care units and had an antimicrobial therapy prescribed and assessed by different strategies: Bundled Antimicrobial Stewardship Program (bundled intervention consisted of clinical pharmacist chart review, discussion with microbiologist and infectious disease physicians, local education and continuous follow-up) or Conventional Antimicrobial Stewardship Program (clinical pharmacist chart review and discussion with infectious disease physician). Primary outcome from this study was 30-day mortality, which was compared between groups, by using Kaplan-Meier survival curve and log-rank test. Other outcomes included Defined Daily Doses per 1000 patient-days and occurrence of resistant bacteria.
resultsFrom 533 patients, 491 were eligible for the study, of which 191 patients were included to Antimicrobial Stewardship Program and 300 to Conventional strategy. In general, they were likely to be male and age was similar in groups (58.9 vs 55.5 years, p=0.38). Likewise, Charlson Comorbidity Index was not statistically different between groups (2.6 vs 2.7, p=0.2). Bloodstream site infections were frequently diagnosed in both groups (30.89% vs 26%, p=0.24). Other less common sites of infections were central nervous system and lungs. The ASP group had higher survival rates (p<0.01) and the risk difference was 10.8% (95% CI: 2.41-19.14). There were less Defined Daily Doses per 1000 patient-days (417 vs 557.2, p<0.05) and higher rates of resistant bacteria identified in the ASP group (83% vs 17%).
conclusionBundled ASP was the most effective strategy, with reduced mortality and Defined Daily Doses per 1000 patient-days.
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