The Impact of the SARS-Cov2 Pandemic on a Persuasive Educational Antimicrobial Stewardship Program in a University Hospital in Southern Italy: A Pre-Post Study
Objectives: We evaluated the effect of the pandemic on the disruption of a persuasive educational antimicrobial stewardship program (ASP) conducted in a university hospital in southern Italy. Methods: In March 2020, the ASP, which began in January 2017 and was carried out at different times in 10 wa...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-11-01
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| Series: | Antibiotics |
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| Online Access: | https://www.mdpi.com/2079-6382/10/11/1405 |
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| author | Margherita Macera Lorenzo Onorato Federica Calò Caterina Monari Rosa Annibale Giuseppe Signoriello Giovanna Donnarumma Maria Vittoria Montemurro Massimiliano Galdiero Nicola Coppola |
| author_facet | Margherita Macera Lorenzo Onorato Federica Calò Caterina Monari Rosa Annibale Giuseppe Signoriello Giovanna Donnarumma Maria Vittoria Montemurro Massimiliano Galdiero Nicola Coppola |
| author_sort | Margherita Macera |
| collection | DOAJ |
| description | Objectives: We evaluated the effect of the pandemic on the disruption of a persuasive educational antimicrobial stewardship program (ASP) conducted in a university hospital in southern Italy. Methods: In March 2020, the ASP, which began in January 2017 and was carried out at different times in 10 wards, was stopped due to the COVID-19 pandemic. We conducted an observational study with interrupted time series analysis to compare the antibiotic consumption and costs, average length of hospital stay and in-hospital mortality between 12 months before and 9 months after the interruption. Results: Four medical, four surgical wards and two ICUs were included in the study, for a total of 35,921 patient days. Among the medical wards we observed after the interruption a significant increase in fluoroquinolone use, with a change in trend (CT) of 0.996, <i>p</i> = 0.027. In the surgical wards, we observed a significant increase in the overall consumption, with a change in level (CL) of 24.4, <i>p</i> = 0.005, and in the use of third and fourth generation cephalosporins (CL 4.7, <i>p</i> = 0.003). In two ICUs, we observed a significant increase in piperacillin/tazobactam and fluoroquinolone consumption (CT 9.28, <i>p</i> = 0.019, and 2.4, <i>p</i> = 0.047). In the wards with a duration of ASP less than 30 months, we observed a significant increase in antibiotic consumption in the use of piperacillin/tazobactam and fluoroquinolones (CT 12.9, <i>p</i> = 0.022: 4.12, <i>p</i> = 0.029; 1.004, <i>p</i> = 0.011). Conclusions: The interruption of ASP during COVID-19 led to an increase in the consumption of broad-spectrum antibiotics, particularly in surgical wards and in those with a duration of ASP less than 30 months. |
| first_indexed | 2024-03-10T05:45:34Z |
| format | Article |
| id | doaj.art-cb0a147f38c241f09f749b572178ec0c |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-10T05:45:34Z |
| publishDate | 2021-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-cb0a147f38c241f09f749b572178ec0c2023-11-22T22:11:10ZengMDPI AGAntibiotics2079-63822021-11-011011140510.3390/antibiotics10111405The Impact of the SARS-Cov2 Pandemic on a Persuasive Educational Antimicrobial Stewardship Program in a University Hospital in Southern Italy: A Pre-Post StudyMargherita Macera0Lorenzo Onorato1Federica Calò2Caterina Monari3Rosa Annibale4Giuseppe Signoriello5Giovanna Donnarumma6Maria Vittoria Montemurro7Massimiliano Galdiero8Nicola Coppola9Department of Mental Health and Public Medicine, Section of Infectious Diseases, University of Campania Luigi Vanvitelli, 80138 Naples, ItalyDepartment of Mental Health and Public Medicine, Section of Infectious Diseases, University of Campania Luigi Vanvitelli, 80138 Naples, ItalyDepartment of Mental Health and Public Medicine, Section of Infectious Diseases, University of Campania Luigi Vanvitelli, 80138 Naples, ItalyDepartment of Mental Health and Public Medicine, Section of Infectious Diseases, University of Campania Luigi Vanvitelli, 80138 Naples, ItalyPharmacy Unit, AOU Vanvitelli, 80138 Naples, ItalyDepartment of Mental Health and Public Medicine-Medical Statistics Unit, University of Campania Luigi Vanvitelli, 80138 Naples, ItalyDepartment of Experimental Medicine, University of Campania Luigi Vanvitelli, 80138 Naples, ItalyDirezione Sanitaria, AOU Vanvitelli, 80138 Naples, ItalyDepartment of Experimental Medicine, University of Campania Luigi Vanvitelli, 80138 Naples, ItalyDepartment of Mental Health and Public Medicine, Section of Infectious Diseases, University of Campania Luigi Vanvitelli, 80138 Naples, ItalyObjectives: We evaluated the effect of the pandemic on the disruption of a persuasive educational antimicrobial stewardship program (ASP) conducted in a university hospital in southern Italy. Methods: In March 2020, the ASP, which began in January 2017 and was carried out at different times in 10 wards, was stopped due to the COVID-19 pandemic. We conducted an observational study with interrupted time series analysis to compare the antibiotic consumption and costs, average length of hospital stay and in-hospital mortality between 12 months before and 9 months after the interruption. Results: Four medical, four surgical wards and two ICUs were included in the study, for a total of 35,921 patient days. Among the medical wards we observed after the interruption a significant increase in fluoroquinolone use, with a change in trend (CT) of 0.996, <i>p</i> = 0.027. In the surgical wards, we observed a significant increase in the overall consumption, with a change in level (CL) of 24.4, <i>p</i> = 0.005, and in the use of third and fourth generation cephalosporins (CL 4.7, <i>p</i> = 0.003). In two ICUs, we observed a significant increase in piperacillin/tazobactam and fluoroquinolone consumption (CT 9.28, <i>p</i> = 0.019, and 2.4, <i>p</i> = 0.047). In the wards with a duration of ASP less than 30 months, we observed a significant increase in antibiotic consumption in the use of piperacillin/tazobactam and fluoroquinolones (CT 12.9, <i>p</i> = 0.022: 4.12, <i>p</i> = 0.029; 1.004, <i>p</i> = 0.011). Conclusions: The interruption of ASP during COVID-19 led to an increase in the consumption of broad-spectrum antibiotics, particularly in surgical wards and in those with a duration of ASP less than 30 months.https://www.mdpi.com/2079-6382/10/11/1405SARS-CoV-2antimicrobial stewardship programDDDantimicrobial resistanceCOVID-19 |
| spellingShingle | Margherita Macera Lorenzo Onorato Federica Calò Caterina Monari Rosa Annibale Giuseppe Signoriello Giovanna Donnarumma Maria Vittoria Montemurro Massimiliano Galdiero Nicola Coppola The Impact of the SARS-Cov2 Pandemic on a Persuasive Educational Antimicrobial Stewardship Program in a University Hospital in Southern Italy: A Pre-Post Study Antibiotics SARS-CoV-2 antimicrobial stewardship program DDD antimicrobial resistance COVID-19 |
| title | The Impact of the SARS-Cov2 Pandemic on a Persuasive Educational Antimicrobial Stewardship Program in a University Hospital in Southern Italy: A Pre-Post Study |
| title_full | The Impact of the SARS-Cov2 Pandemic on a Persuasive Educational Antimicrobial Stewardship Program in a University Hospital in Southern Italy: A Pre-Post Study |
| title_fullStr | The Impact of the SARS-Cov2 Pandemic on a Persuasive Educational Antimicrobial Stewardship Program in a University Hospital in Southern Italy: A Pre-Post Study |
| title_full_unstemmed | The Impact of the SARS-Cov2 Pandemic on a Persuasive Educational Antimicrobial Stewardship Program in a University Hospital in Southern Italy: A Pre-Post Study |
| title_short | The Impact of the SARS-Cov2 Pandemic on a Persuasive Educational Antimicrobial Stewardship Program in a University Hospital in Southern Italy: A Pre-Post Study |
| title_sort | impact of the sars cov2 pandemic on a persuasive educational antimicrobial stewardship program in a university hospital in southern italy a pre post study |
| topic | SARS-CoV-2 antimicrobial stewardship program DDD antimicrobial resistance COVID-19 |
| url | https://www.mdpi.com/2079-6382/10/11/1405 |
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