Effectiveness and Acceptance of Multimodal Antibiotic Stewardship Program: Considering Progressive Implementation and Complementary Strategies
Multiple modes of interventions are available when implementing an antibiotic stewardship program (ASP), however, their complementarity has not yet been assessed. In a 938-bed hospital, we sequentially implemented four combined modes of interventions over one year, centralized by one infectious dise...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-11-01
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| Series: | Antibiotics |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2079-6382/9/12/848 |
| _version_ | 1827701362460196864 |
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| author | Flavien Bouchet Vincent Le Moing Delphine Dirand François Cros Alexi Lienard Jacques Reynes Laurent Giraudon David Morquin |
| author_facet | Flavien Bouchet Vincent Le Moing Delphine Dirand François Cros Alexi Lienard Jacques Reynes Laurent Giraudon David Morquin |
| author_sort | Flavien Bouchet |
| collection | DOAJ |
| description | Multiple modes of interventions are available when implementing an antibiotic stewardship program (ASP), however, their complementarity has not yet been assessed. In a 938-bed hospital, we sequentially implemented four combined modes of interventions over one year, centralized by one infectious diseases specialist (IDS): (1) on-request infectious diseases specialist consulting service (IDSCS), (2) participation in intensive care unit meetings, (3) IDS intervention triggered by microbiological laboratory meetings, and (4) IDS intervention triggered by pharmacist alert. We assessed the complementarity of the different cumulative actions through quantitative and qualitative analysis of all interventions traced in the electronic medical record. We observed a quantitative and qualitative complementarity between interventions directly correlating to a decrease in antibiotic use. Quantitatively, the number of interventions has doubled after implementation of IDS intervention triggered by pharmacist alert. Qualitatively, these kinds of interventions led mainly to de-escalation or stopping of antibiotic therapy (63%) as opposed to on-request IDSCS (32%). An overall decrease of 14.6% in antibiotic use was observed (<i>p</i> = 0.03). Progressive implementation of the different interventions showed a concrete complementarity of these actions. Combined actions in ASPs could lead to a significant decrease in antibiotic use, especially regarding critical antibiotic prescriptions, while being well accepted by prescribers. |
| first_indexed | 2024-03-10T14:32:31Z |
| format | Article |
| id | doaj.art-e8596409166a46a09b04cbbb3876ecd6 |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-10T14:32:31Z |
| publishDate | 2020-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-e8596409166a46a09b04cbbb3876ecd62023-11-20T22:32:26ZengMDPI AGAntibiotics2079-63822020-11-0191284810.3390/antibiotics9120848Effectiveness and Acceptance of Multimodal Antibiotic Stewardship Program: Considering Progressive Implementation and Complementary StrategiesFlavien Bouchet0Vincent Le Moing1Delphine Dirand2François Cros3Alexi Lienard4Jacques Reynes5Laurent Giraudon6David Morquin7Service de Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Montpellier, Université de Montpellier, 34000 Montpellier, FranceService de Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Montpellier, Université de Montpellier, 34000 Montpellier, FrancePôle Appui aux Fonctions Cliniques, Département de la Pharmacie, Hôpitaux du Bassin de Thau, 34200 Sète, FranceDépartement Informatique, Hôpitaux du Bassin de Thau, 34200 Sète, FranceDépartement de Biologie Médicale, Hôpitaux du Bassin de Thau, 34200 Sète, FranceService de Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Montpellier, Université de Montpellier, 34000 Montpellier, FrancePôle Appui aux Fonctions Cliniques, Département de la Pharmacie, Hôpitaux du Bassin de Thau, 34200 Sète, FranceService de Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Montpellier, Université de Montpellier, 34000 Montpellier, FranceMultiple modes of interventions are available when implementing an antibiotic stewardship program (ASP), however, their complementarity has not yet been assessed. In a 938-bed hospital, we sequentially implemented four combined modes of interventions over one year, centralized by one infectious diseases specialist (IDS): (1) on-request infectious diseases specialist consulting service (IDSCS), (2) participation in intensive care unit meetings, (3) IDS intervention triggered by microbiological laboratory meetings, and (4) IDS intervention triggered by pharmacist alert. We assessed the complementarity of the different cumulative actions through quantitative and qualitative analysis of all interventions traced in the electronic medical record. We observed a quantitative and qualitative complementarity between interventions directly correlating to a decrease in antibiotic use. Quantitatively, the number of interventions has doubled after implementation of IDS intervention triggered by pharmacist alert. Qualitatively, these kinds of interventions led mainly to de-escalation or stopping of antibiotic therapy (63%) as opposed to on-request IDSCS (32%). An overall decrease of 14.6% in antibiotic use was observed (<i>p</i> = 0.03). Progressive implementation of the different interventions showed a concrete complementarity of these actions. Combined actions in ASPs could lead to a significant decrease in antibiotic use, especially regarding critical antibiotic prescriptions, while being well accepted by prescribers.https://www.mdpi.com/2079-6382/9/12/848antibiotic stewardship programcomplementarityprospective audit and feedback |
| spellingShingle | Flavien Bouchet Vincent Le Moing Delphine Dirand François Cros Alexi Lienard Jacques Reynes Laurent Giraudon David Morquin Effectiveness and Acceptance of Multimodal Antibiotic Stewardship Program: Considering Progressive Implementation and Complementary Strategies Antibiotics antibiotic stewardship program complementarity prospective audit and feedback |
| title | Effectiveness and Acceptance of Multimodal Antibiotic Stewardship Program: Considering Progressive Implementation and Complementary Strategies |
| title_full | Effectiveness and Acceptance of Multimodal Antibiotic Stewardship Program: Considering Progressive Implementation and Complementary Strategies |
| title_fullStr | Effectiveness and Acceptance of Multimodal Antibiotic Stewardship Program: Considering Progressive Implementation and Complementary Strategies |
| title_full_unstemmed | Effectiveness and Acceptance of Multimodal Antibiotic Stewardship Program: Considering Progressive Implementation and Complementary Strategies |
| title_short | Effectiveness and Acceptance of Multimodal Antibiotic Stewardship Program: Considering Progressive Implementation and Complementary Strategies |
| title_sort | effectiveness and acceptance of multimodal antibiotic stewardship program considering progressive implementation and complementary strategies |
| topic | antibiotic stewardship program complementarity prospective audit and feedback |
| url | https://www.mdpi.com/2079-6382/9/12/848 |
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