Evidence map›Paper›PMID 37700179›Full record

ArticleInternal and emergency medicine2024

The impact of a non-restrictive Antimicrobial Stewardship Program in the emergency department of a secondary-level Italian hospital.

Caterina Monari, Lorenzo Onorato, Enrico Allegorico, Valentina Minerva, Margherita Macera, Giorgio Bosso, Federica Calò, Antonio Pagano, Teresa Russo, Gennaro Sansone and 5 more

Open access · hybridAbstract read
In one paragraph

Article in Internal and emergency medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.5field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 2 institutions in 1 country.

Caterina Monari *Infectious Diseases Unit, Section of Infectious Diseases, Department of Mental Health and Public Medicine, University of Campania Luigi Vanvitelli, Via L. Armanni 5, 80131, Naples, Italy.
Lorenzo Onorato *Infectious Diseases Unit, Section of Infectious Diseases, Department of Mental Health and Public Medicine, University of Campania Luigi Vanvitelli, Via L. Armanni 5, 80131, Naples, Italy.
Enrico AllegoricoDepartment of Emergency and Critical Care, "Santa Maria Delle Grazie Hospital", Pozzuoli, Italy.
Valentina MinervaDepartment of Emergency and Critical Care, "Santa Maria Delle Grazie Hospital", Pozzuoli, Italy.
Margherita MaceraInfectious Diseases Unit, Section of Infectious Diseases, Department of Mental Health and Public Medicine, University of Campania Luigi Vanvitelli, Via L. Armanni 5, 80131, Naples, Italy.
Giorgio BossoDepartment of Emergency and Critical Care, "Santa Maria Delle Grazie Hospital", Pozzuoli, Italy.
Federica CalòInfectious Diseases Unit, Section of Infectious Diseases, Department of Mental Health and Public Medicine, University of Campania Luigi Vanvitelli, Via L. Armanni 5, 80131, Naples, Italy.
Antonio PaganoDepartment of Emergency and Critical Care, "Santa Maria Delle Grazie Hospital", Pozzuoli, Italy.
Teresa RussoDepartment of Emergency and Critical Care, "Santa Maria Delle Grazie Hospital", Pozzuoli, Italy.
Gennaro SansoneDepartment of Emergency and Critical Care, "Santa Maria Delle Grazie Hospital", Pozzuoli, Italy.
Marina D'IsantoMicrobiology Unit, "Santa Maria Delle Grazie Hospital", Pozzuoli, Italy.
Antonio CasciottaDepartment of Pharmacology, "Santa Maria Delle Grazie Hospital, Pozzuoli, Italy.
Monica VanniASL NAPOLI 2 Nord, Pozzuoli, Italy.
Fabio Giuliano NumisDepartment of Emergency and Critical Care, "Santa Maria Delle Grazie Hospital", Pozzuoli, Italy.
Nicola CoppolaInfectious Diseases Unit, Section of Infectious Diseases, Department of Mental Health and Public Medicine, University of Campania Luigi Vanvitelli, Via L. Armanni 5, 80131, Naples, Italy. nicola.coppola@unicampania.it.ORCID 0000-0001-5897-4949
Ospedale Santa Maria · ITUniversity of Campania "Luigi Vanvitelli" · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Evidence supporting the effectiveness of Antimicrobial Stewardship (AMS) Programs in the emergency department (ED) setting is limited. We conducted a prospective cohort study to assess the efficacy of an AMS program in an ED and a short-stay observation unit. The intervention included periodic prospective audits (twice a week), conducted by four infectious disease consultants. Primary outcomes included the difference in the hospital mortality rate, antibiotic consumption, and the incidence of bloodstream infections (BSI) caused by multidrug resistant (MDR) bacteria, before March 2020-February 2021 and after March 2021-February 2022 when the program was implemented. Interrupted time-series analysis was performed to assess the effect of our program. During the 12-month program, we performed 152 audits and evaluated 366 antibiotic therapies out of a total of 853 patients admitted. In the intervention period, we observed a non-statistically significant decrease in total antibiotic consumption, with a change in level of - 31.2 defined daily dose/100 patient-days (PD) (p = 0.71). Likewise, we found no significant variations in the rate of BSI due to MDR Gram-positive (CT - 0.02 events/PD, p = 0.84), MDR Gram-negative bacteria (CT 0.08, p = 0.71), or Candida spp. (CT 0.008, p = 0.86). Conversely, we found a significant decrease in the mortality rate between the pre- and post-intervention periods (- 1.98 deaths/100 PD, CI - 3.9 to - 0.007, p = 0.049). The Antibiotic Stewardship Program in the ED was associated with a significant decrease in the mortality rate. More high-quality studies are needed to determine the most effective ASP strategies in this unique setting.

Indexed as

Antimicrobial StewardshipAnti-Bacterial AgentsEmergency Service, HospitalHospitalsHumansItalyProspective StudiesAnti-Bacterial AgentsAntimicrobial stewardshipAuditDDIEmergency departmentMDR

Identifiers

PMID37700179
PMCPMC10954915
OpenAlexW4386691454

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.