ArticleEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2026
Effect of an antibiotic stewardship program on antimicrobial use and resistance in a high prescribing, high resistance setting: A single-center, interrupted time series analysis.
Article in European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04261348 (Effects of an Antimicrobial Stewardship), which is not on this map. Not yet cited in PubMed.
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Effects of an Antimicrobial Stewardship (AMS) Program, on the Prevalence of Multidrug-resistant Gram - Negative Pathogens, in an Area of High Consumption of Antibiotics and High Resistance Rates
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9 authors.
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Abstract
purposeTo assess the impact of an antimicrobial stewardship (AMS) program on antimicrobial use and resistance rates in a tertiary care hospital situated in a region with high antimicrobial consumption and antimicrobial resistance (AMR) prevalence.
methodWe conducted a quasi-experimental study, using interrupted time-series (ITS) design. The intervention consisted of a targeted prospective audit and feedback (PAF) strategy, in which the antimicrobial stewardship team (AST) was reviewing all prescriptions for carbapenems, colistin and tigecycline (i.e., "targeted" antimicrobials). We compared the period before (January 2014 - October 2016) and after the introduction of the PAF strategy (November 2016 - December 2019). The main metric of antimicrobial consumption was defined daily doses (DDDs) per 100 patient-days.
resultsITS analysis showed that carbapenem consumption decreased significantly after the intervention [level change - 10.170 DDDs/100 patient-days (95% CI: -13.058, -7.282); p: <0.001] but remained stable thereafter [post-intervention yearly slope: 0.966 DDDs/100 patient-days (95% CI: -0.433, 2.366); p: 0.173]. Consumption of colistin and tigecycline also decreased significantly, however, ITS analysis showed an increasing trend in total antimicrobial consumption (yearly slope 0.668 DDDs/100 patient-days (95% CI: 0.162, 1.173; p: 0.010). Regarding carbapenem resistance, ITS analysis showed that after the PAF intervention there was a significant increase at level and a non-significant trend towards increase post-intervention.
conclusionsThe implementation of PAF intervention in a setting with high antimicrobial consumption and resistance led to a significant reduction in the use of targeted antimicrobials, although total antimicrobial consumption showed an increasing trend. The effect of the AMS program on resistance rates was minimal. TRIAL REGISTRATION NUMBER: NCT04261348.
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