Impact of prolonged carbapenem use-focused antimicrobial stewardship on antimicrobial consumption and factors affecting acceptance of recommendations: a quasi-experimental study
Abstract This study aimed to assess the impact of a prolonged carbapenem use-focused antimicrobial stewardship program (ASP) on antimicrobial consumption and clinical outcomes and to analyze factors affecting adherence to interventions. Patients prescribed carbapenems for ≥ 2 weeks received interven...
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2023-09-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-023-41710-4 |
| _version_ | 1827723541095645184 |
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| author | Jin Sae Yoo Jeong Yong Park Ha-Jin Chun Young Rong Kim Eun Jin Kim Young Hwa Choi Kyoung Hwa Ha Jung Yeon Heo |
| author_facet | Jin Sae Yoo Jeong Yong Park Ha-Jin Chun Young Rong Kim Eun Jin Kim Young Hwa Choi Kyoung Hwa Ha Jung Yeon Heo |
| author_sort | Jin Sae Yoo |
| collection | DOAJ |
| description | Abstract This study aimed to assess the impact of a prolonged carbapenem use-focused antimicrobial stewardship program (ASP) on antimicrobial consumption and clinical outcomes and to analyze factors affecting adherence to interventions. Patients prescribed carbapenems for ≥ 2 weeks received intervention. Interrupted time-series analysis was performed to compare antimicrobial consumption before and after intervention. Factors associated with non-adherence to intervention were investigated. Of 273 patients who were eligible for intervention, discontinuation or de-escalation was recommended in 256 (94.1%) and intervention was accepted in 136 (53.1%) patients. Before intervention, carbapenem consumption significantly increased to 1.14 days of therapy (DOT)/1000 patient days (PD)/month (P = 0.018). However, it significantly declined by − 2.01 DOT/1000 PD/month without an increase in other antibiotic consumption (P < 0.001). Factors affecting non-adherence to intervention were younger age (odds ratio [OR] = 0.98; 95% confidence interval [CI] 0.96–1.00), solid organ malignancy (OR = 2.53, 95% CI 1.16–5.50), and pneumonia (OR = 2.59, 95% CI 1.08–6.17). However, ASP intervention was not associated with clinical outcomes such as length of hospital stay or mortality. Prolonged carbapenem prescription-focused ASP significantly reduced carbapenem consumption without adverse outcomes. Non-adherence to interventions was attributed more to prescriber-related factors, such as attitude, than patient-related factors including clinical severity. |
| first_indexed | 2024-03-10T22:02:11Z |
| format | Article |
| id | doaj.art-4208d5216eaa471a985e575f0ffdd37d |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-03-10T22:02:11Z |
| publishDate | 2023-09-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-4208d5216eaa471a985e575f0ffdd37d2023-11-19T12:55:19ZengNature PortfolioScientific Reports2045-23222023-09-011311910.1038/s41598-023-41710-4Impact of prolonged carbapenem use-focused antimicrobial stewardship on antimicrobial consumption and factors affecting acceptance of recommendations: a quasi-experimental studyJin Sae Yoo0Jeong Yong Park1Ha-Jin Chun2Young Rong Kim3Eun Jin Kim4Young Hwa Choi5Kyoung Hwa Ha6Jung Yeon Heo7Department of Infectious Diseases, Ajou University School of MedicineDepartment of Pharmaceutical Service, Ajou University HospitalDepartment of Pharmaceutical Service, Ajou University HospitalDepartment of Infectious Diseases, Ajou University School of MedicineDepartment of Infectious Diseases, Ajou University School of MedicineDepartment of Infectious Diseases, Ajou University School of MedicineDepartment of Endocrinology and Metabolism, Ajou University School of Medicine, Ajou University School of MedicineDepartment of Infectious Diseases, Ajou University School of MedicineAbstract This study aimed to assess the impact of a prolonged carbapenem use-focused antimicrobial stewardship program (ASP) on antimicrobial consumption and clinical outcomes and to analyze factors affecting adherence to interventions. Patients prescribed carbapenems for ≥ 2 weeks received intervention. Interrupted time-series analysis was performed to compare antimicrobial consumption before and after intervention. Factors associated with non-adherence to intervention were investigated. Of 273 patients who were eligible for intervention, discontinuation or de-escalation was recommended in 256 (94.1%) and intervention was accepted in 136 (53.1%) patients. Before intervention, carbapenem consumption significantly increased to 1.14 days of therapy (DOT)/1000 patient days (PD)/month (P = 0.018). However, it significantly declined by − 2.01 DOT/1000 PD/month without an increase in other antibiotic consumption (P < 0.001). Factors affecting non-adherence to intervention were younger age (odds ratio [OR] = 0.98; 95% confidence interval [CI] 0.96–1.00), solid organ malignancy (OR = 2.53, 95% CI 1.16–5.50), and pneumonia (OR = 2.59, 95% CI 1.08–6.17). However, ASP intervention was not associated with clinical outcomes such as length of hospital stay or mortality. Prolonged carbapenem prescription-focused ASP significantly reduced carbapenem consumption without adverse outcomes. Non-adherence to interventions was attributed more to prescriber-related factors, such as attitude, than patient-related factors including clinical severity.https://doi.org/10.1038/s41598-023-41710-4 |
| spellingShingle | Jin Sae Yoo Jeong Yong Park Ha-Jin Chun Young Rong Kim Eun Jin Kim Young Hwa Choi Kyoung Hwa Ha Jung Yeon Heo Impact of prolonged carbapenem use-focused antimicrobial stewardship on antimicrobial consumption and factors affecting acceptance of recommendations: a quasi-experimental study Scientific Reports |
| title | Impact of prolonged carbapenem use-focused antimicrobial stewardship on antimicrobial consumption and factors affecting acceptance of recommendations: a quasi-experimental study |
| title_full | Impact of prolonged carbapenem use-focused antimicrobial stewardship on antimicrobial consumption and factors affecting acceptance of recommendations: a quasi-experimental study |
| title_fullStr | Impact of prolonged carbapenem use-focused antimicrobial stewardship on antimicrobial consumption and factors affecting acceptance of recommendations: a quasi-experimental study |
| title_full_unstemmed | Impact of prolonged carbapenem use-focused antimicrobial stewardship on antimicrobial consumption and factors affecting acceptance of recommendations: a quasi-experimental study |
| title_short | Impact of prolonged carbapenem use-focused antimicrobial stewardship on antimicrobial consumption and factors affecting acceptance of recommendations: a quasi-experimental study |
| title_sort | impact of prolonged carbapenem use focused antimicrobial stewardship on antimicrobial consumption and factors affecting acceptance of recommendations a quasi experimental study |
| url | https://doi.org/10.1038/s41598-023-41710-4 |
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