Antibiotic stewardship implementation at the largest solid organ transplantation center in Asia: a retrospective cohort study

Abstract Background Using Antimicrobial stewardship programs (ASP) to monitor the use of antibiotics can lead to improved antibiotic use and reduced costs. Methods This retrospective cohort study was done at Shiraz Organ Transplant Center, the largest transplant center in Asia. Antimicrobial use, co...

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Main Authors: Mojtaba Shafiekhani, Mojtaba Shabani-Borujeni, Ava Karimian, Mohammad Javad MomeniTabar, Zahra Zare, Sara Arabsheybani, Afsaneh Vazin
Format: Article
Language:English
Published: BMC 2023-04-01
Series:BMC Surgery
Subjects:
Online Access:https://doi.org/10.1186/s12893-023-01991-y
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author Mojtaba Shafiekhani
Mojtaba Shabani-Borujeni
Ava Karimian
Mohammad Javad MomeniTabar
Zahra Zare
Sara Arabsheybani
Afsaneh Vazin
author_facet Mojtaba Shafiekhani
Mojtaba Shabani-Borujeni
Ava Karimian
Mohammad Javad MomeniTabar
Zahra Zare
Sara Arabsheybani
Afsaneh Vazin
author_sort Mojtaba Shafiekhani
collection DOAJ
description Abstract Background Using Antimicrobial stewardship programs (ASP) to monitor the use of antibiotics can lead to improved antibiotic use and reduced costs. Methods This retrospective cohort study was done at Shiraz Organ Transplant Center, the largest transplant center in Asia. Antimicrobial use, cost, clinical outcomes, and antibiotic resistance pattern were evaluated before and after ASP. Results This study included 2791 patients, 1154 of whom were related to the time before ASP and 1637 to the time after ASP. During the period of the research, a total of 4051 interventions were done. The use of all classes of antibiotics was significantly reduced by ASP, with 329 DDD/100PD before the intervention compared to 201 DDD/100PD after it (p = 0.04). In addition, the overall cost of antibiotics purchased was much lower after the ASP measures were implemented ($43.10 per PD) than before implementation of the ASP measures ($60.60 per PD) (p = 0.03). After the implementation of ASP, the number of MDR isolates was significantly reduced. Conclusion The results of our study showed that the implementation of ASP significantly reduced the number and costs of antibiotics and also the number of resistant pathogens, but did not affect the patients’ length of stay.
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spelling doaj.art-f904268a69bb4edda8084acaed8401e92023-04-16T11:05:48ZengBMCBMC Surgery1471-24822023-04-012311810.1186/s12893-023-01991-yAntibiotic stewardship implementation at the largest solid organ transplantation center in Asia: a retrospective cohort studyMojtaba Shafiekhani0Mojtaba Shabani-Borujeni1Ava Karimian2Mohammad Javad MomeniTabar3Zahra Zare4Sara Arabsheybani5Afsaneh Vazin6Transplant Research Center, Shiraz University of Medical SciencesDepartment of Clinical Pharmacy, Faculty of Pharmacy, Shiraz University of Medical SciencesDepartment of Clinical Pharmacy, Faculty of Pharmacy, Shiraz University of Medical SciencesDepartment of Clinical Pharmacy, Faculty of Pharmacy, Shiraz University of Medical SciencesShiraz Transplant Center, Abu-Ali Sina Hospital, Shiraz University of Medical SciencesShiraz Transplant Center, Abu-Ali Sina Hospital, Shiraz University of Medical SciencesDepartment of Clinical Pharmacy, Faculty of Pharmacy, Shiraz University of Medical SciencesAbstract Background Using Antimicrobial stewardship programs (ASP) to monitor the use of antibiotics can lead to improved antibiotic use and reduced costs. Methods This retrospective cohort study was done at Shiraz Organ Transplant Center, the largest transplant center in Asia. Antimicrobial use, cost, clinical outcomes, and antibiotic resistance pattern were evaluated before and after ASP. Results This study included 2791 patients, 1154 of whom were related to the time before ASP and 1637 to the time after ASP. During the period of the research, a total of 4051 interventions were done. The use of all classes of antibiotics was significantly reduced by ASP, with 329 DDD/100PD before the intervention compared to 201 DDD/100PD after it (p = 0.04). In addition, the overall cost of antibiotics purchased was much lower after the ASP measures were implemented ($43.10 per PD) than before implementation of the ASP measures ($60.60 per PD) (p = 0.03). After the implementation of ASP, the number of MDR isolates was significantly reduced. Conclusion The results of our study showed that the implementation of ASP significantly reduced the number and costs of antibiotics and also the number of resistant pathogens, but did not affect the patients’ length of stay.https://doi.org/10.1186/s12893-023-01991-ySolid organ transplantationAntibiotic stewardshipAntibiotic resistanceKidney transplantationLiver transplantation
spellingShingle Mojtaba Shafiekhani
Mojtaba Shabani-Borujeni
Ava Karimian
Mohammad Javad MomeniTabar
Zahra Zare
Sara Arabsheybani
Afsaneh Vazin
Antibiotic stewardship implementation at the largest solid organ transplantation center in Asia: a retrospective cohort study
BMC Surgery
Solid organ transplantation
Antibiotic stewardship
Antibiotic resistance
Kidney transplantation
Liver transplantation
title Antibiotic stewardship implementation at the largest solid organ transplantation center in Asia: a retrospective cohort study
title_full Antibiotic stewardship implementation at the largest solid organ transplantation center in Asia: a retrospective cohort study
title_fullStr Antibiotic stewardship implementation at the largest solid organ transplantation center in Asia: a retrospective cohort study
title_full_unstemmed Antibiotic stewardship implementation at the largest solid organ transplantation center in Asia: a retrospective cohort study
title_short Antibiotic stewardship implementation at the largest solid organ transplantation center in Asia: a retrospective cohort study
title_sort antibiotic stewardship implementation at the largest solid organ transplantation center in asia a retrospective cohort study
topic Solid organ transplantation
Antibiotic stewardship
Antibiotic resistance
Kidney transplantation
Liver transplantation
url https://doi.org/10.1186/s12893-023-01991-y
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