ArticleInfection control and hospital epidemiology2022
Impact of cascade reporting of antimicrobial susceptibility on fluoroquinolone and meropenem consumption at a Veterans' Affairs medical center.
Article in Infection control and hospital epidemiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Improvements in antimicrobial reporting in Australian and New Zealand laboratories after publication of national guidelines: a follow-up survey from the Royal College of Pathologists of Australasia Quality Assurance Programs.JAC-antimicrobial resistance · 2026Article
- Point-Counterpoint: Cascade reporting-useful tool to support antimicrobial stewardship, or dangerously misleading.Journal of clinical microbiology · 2025Review
- Article
- A decade of clinical microbiology: top 10 advances in 10 years: what every infection preventionist and antimicrobial steward should know.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2024Review
- The importance of pharmacist engagement in diagnostic stewardship.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2024Article
- Implementing diagnostic stewardship to improve diagnosis of urinary tract infections across three medical centers: A qualitative assessment.Infection control and hospital epidemiology · 2023Article
- Leveraging diagnostic stewardship within antimicrobial stewardship programmes.Drugs in context · 2023Review
- Applying Diagnostic Stewardship to Proactively Optimize the Management of Urinary Tract Infections.Antibiotics (Basel, Switzerland) · 2022Review
- Assessment of Knowledge Regarding Safety Profile, Use, and Boxed Warnings of Fluoroquinolones Among Healthcare Professionals in Saudi Arabia: A Potential Implication for Drug Regulatory Authorities.Frontiers in medicine · 2022Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
objectiveTo determine whether cascade reporting is associated with a change in meropenem and fluoroquinolone consumption.
designA quasi-experimental study was conducted using an interrupted time series to compare antimicrobial consumption before and after the implementation of cascade reporting.
settingA 399-bed, tertiary-care, Veterans' Affairs medical center.
participantsAntimicrobial consumption data across 8 inpatient units were extracted from the Center for Disease Control and Prevention (CDC) National Health Safety Network (NHSN) antimicrobial use (AU) module from April 2017 through March 2019, reported as antimicrobial days of therapy (DOT) per 1,000 days present (DP).
interventionCascade reporting is a strategy of reporting antimicrobial susceptibility test results in which secondary agents are only reported if an organism is resistant to primary, narrow-spectrum agents. A multidisciplinary team developed cascade reporting algorithms for gram-negative bacteria based on local antibiogram and infectious diseases practice guidelines, aimed at restricting the use of fluoroquinolones and carbapenems. The algorithms were implemented in March 2018.
resultsFollowing the implementation of cascade reporting, mean monthly meropenem (P =.005) and piperacillin/tazobactam (P = .002) consumption decreased and cefepime consumption increased (P < .001). Ciprofloxacin consumption decreased by 2.16 DOT per 1,000 DP per month (SE, 0.25; P < .001). Clostridioides difficile rates did not significantly change.
conclusionCiprofloxacin consumption significantly decreased after the implementation of cascade reporting. Mean meropenem consumption decreased after cascade reporting was implemented, but we observed no significant change in the slope of consumption. cascade reporting may be a useful strategy to optimize antimicrobial prescribing.
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