Impact of Antibiotic Authorisation at Three Provincial Hospitals in Thailand: Results from a Quasi-Experimental Study
Implementing antimicrobial stewardship (AMS) at non-university hospitals is challenging. A quasi-experimental study was conducted to determine the impact of customised antibiotic authorisation implementation on antimicrobial consumption and clinical outcomes at three provincial hospitals in Thailand...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-03-01
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| Series: | Antibiotics |
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| Online Access: | https://www.mdpi.com/2079-6382/11/3/354 |
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| author | Walaiporn Wangchinda Jintana Srisompong Sunee Chayangsu Darat Ruangkriengsin Visanu Thamlikitkul Pornpan Koomanachai Rujipas Sirijatuphat Pinyo Rattanaumpawan |
| author_facet | Walaiporn Wangchinda Jintana Srisompong Sunee Chayangsu Darat Ruangkriengsin Visanu Thamlikitkul Pornpan Koomanachai Rujipas Sirijatuphat Pinyo Rattanaumpawan |
| author_sort | Walaiporn Wangchinda |
| collection | DOAJ |
| description | Implementing antimicrobial stewardship (AMS) at non-university hospitals is challenging. A quasi-experimental study was conducted to determine the impact of customised antibiotic authorisation implementation on antimicrobial consumption and clinical outcomes at three provincial hospitals in Thailand. Customised pre-authorisation of selected restricted antibiotics and post-authorisation of selected controlled antibiotics were undertaken and implemented at each hospital by the local AMS team with guidance from the AMS team at the university hospital. From January 2019–December 2020, there were 1802 selected patients (901 patients during the pre-implementation period and 901 patients during the post-implementation period). The most commonly used targeted antimicrobial was meropenem (49.61%), followed by piperacillin/tazobactam (36.46%). Comparison of the outcomes of the patients during the pre- and post-implementation periods revealed that the mean day of therapy of the targeted antimicrobials was significantly shorter during the post-implementation period (6.24 vs. 7.64 days; <i>p</i> < 0.001), the favourable clinical response (the improvement in all clinical and laboratory parameters at the end of antibiotic therapy) was significantly higher during the post-implementation period (72.70% vs. 68.04%; <i>p</i> = 0.03) and the mean length of hospital stay was significantly shorter during the post-implementation period (15.78 vs. 18.90 days; <i>p</i> < 0.001). In conclusion, implementation of antibiotic authorisation at provincial hospitals under experienced AMS team’s guidance was feasible and useful. The study results could be a good model for the implementation of customised AMS strategies at other hospitals with limited resources. |
| first_indexed | 2024-03-09T20:12:35Z |
| format | Article |
| id | doaj.art-62b746ddd0404c609638382bcaf612b6 |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-09T20:12:35Z |
| publishDate | 2022-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-62b746ddd0404c609638382bcaf612b62023-11-24T00:11:11ZengMDPI AGAntibiotics2079-63822022-03-0111335410.3390/antibiotics11030354Impact of Antibiotic Authorisation at Three Provincial Hospitals in Thailand: Results from a Quasi-Experimental StudyWalaiporn Wangchinda0Jintana Srisompong1Sunee Chayangsu2Darat Ruangkriengsin3Visanu Thamlikitkul4Pornpan Koomanachai5Rujipas Sirijatuphat6Pinyo Rattanaumpawan7Department of Medicine, Division of Infectious Diseases and Tropical Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, ThailandInternal Medicine Unit, Surat Thani Hospital, Surat Thani 84000, ThailandInternal Medicine Unit, Surin Hospital, Surin 32000, ThailandInternal Medicine Unit, Sa Kaeo Crown Prince Hospital, Sa Kaeo 27000, ThailandDepartment of Medicine, Division of Infectious Diseases and Tropical Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, ThailandDepartment of Medicine, Division of Infectious Diseases and Tropical Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, ThailandDepartment of Medicine, Division of Infectious Diseases and Tropical Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, ThailandDepartment of Medicine, Division of Infectious Diseases and Tropical Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, ThailandImplementing antimicrobial stewardship (AMS) at non-university hospitals is challenging. A quasi-experimental study was conducted to determine the impact of customised antibiotic authorisation implementation on antimicrobial consumption and clinical outcomes at three provincial hospitals in Thailand. Customised pre-authorisation of selected restricted antibiotics and post-authorisation of selected controlled antibiotics were undertaken and implemented at each hospital by the local AMS team with guidance from the AMS team at the university hospital. From January 2019–December 2020, there were 1802 selected patients (901 patients during the pre-implementation period and 901 patients during the post-implementation period). The most commonly used targeted antimicrobial was meropenem (49.61%), followed by piperacillin/tazobactam (36.46%). Comparison of the outcomes of the patients during the pre- and post-implementation periods revealed that the mean day of therapy of the targeted antimicrobials was significantly shorter during the post-implementation period (6.24 vs. 7.64 days; <i>p</i> < 0.001), the favourable clinical response (the improvement in all clinical and laboratory parameters at the end of antibiotic therapy) was significantly higher during the post-implementation period (72.70% vs. 68.04%; <i>p</i> = 0.03) and the mean length of hospital stay was significantly shorter during the post-implementation period (15.78 vs. 18.90 days; <i>p</i> < 0.001). In conclusion, implementation of antibiotic authorisation at provincial hospitals under experienced AMS team’s guidance was feasible and useful. The study results could be a good model for the implementation of customised AMS strategies at other hospitals with limited resources.https://www.mdpi.com/2079-6382/11/3/354antimicrobial stewardshipsantibiotic authorizationdrug use evaluation |
| spellingShingle | Walaiporn Wangchinda Jintana Srisompong Sunee Chayangsu Darat Ruangkriengsin Visanu Thamlikitkul Pornpan Koomanachai Rujipas Sirijatuphat Pinyo Rattanaumpawan Impact of Antibiotic Authorisation at Three Provincial Hospitals in Thailand: Results from a Quasi-Experimental Study Antibiotics antimicrobial stewardships antibiotic authorization drug use evaluation |
| title | Impact of Antibiotic Authorisation at Three Provincial Hospitals in Thailand: Results from a Quasi-Experimental Study |
| title_full | Impact of Antibiotic Authorisation at Three Provincial Hospitals in Thailand: Results from a Quasi-Experimental Study |
| title_fullStr | Impact of Antibiotic Authorisation at Three Provincial Hospitals in Thailand: Results from a Quasi-Experimental Study |
| title_full_unstemmed | Impact of Antibiotic Authorisation at Three Provincial Hospitals in Thailand: Results from a Quasi-Experimental Study |
| title_short | Impact of Antibiotic Authorisation at Three Provincial Hospitals in Thailand: Results from a Quasi-Experimental Study |
| title_sort | impact of antibiotic authorisation at three provincial hospitals in thailand results from a quasi experimental study |
| topic | antimicrobial stewardships antibiotic authorization drug use evaluation |
| url | https://www.mdpi.com/2079-6382/11/3/354 |
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