RT Journal Article
T1 Long-Term Impact of an Educational Antimicrobial Stewardship Program on Hospital-Acquired Candidemia and Multidrug-Resistant Bloodstream Infections: A Quasi-Experimental Study of Interrupted Time-Series Analysis
A1 Molina, Jose
A1 Penalva, German
A1 Gil-Navarro, Maria V.
A1 Praena, Julia
A1 Lepe, Jose A.
A1 Perez-Moreno, Maria A.
A1 Ferrandiz, Carmen
A1 Aldabo, Teresa
A1 Aguilar, Manuela
A1 Olbrich, Peter
A1 Jimenez-Mejias, Manuel E.
A1 Gascon, Maria L.
A1 Amaya-Villar, Rosario
A1 Neth, Olaf
A1 Rodriguez-Hernandez, Maria J.
A1 Gutierrez-Pizarraya, Antonio
A1 Garnacho-Montero, Jose
A1 Montero, Cristina
A1 Cano, Josefina
A1 Palomino, Julian
A1 Valencia, Raquel
A1 Alvarez, Rocio
A1 Cordero, Elisa
A1 Herrero, Marta
A1 Cisneros, Jose M.
A1 PRIOAM Team, 
K1 Antimicrobial stewardship programs
K1 antimicrobial resistance
K1 educational interviews
K1 hospital-acquired infections
K1 multidrug-resistant bloodstream infections
K1 Antibiotic stewardship
K1 Klebsiella-pneumoniae
K1 Care
K1 Intervention
K1 Epidemiology
K1 Scotland
K1 Therapy
K1 Society
K1 Region
K1 Panel
AB Background. The global crisis of bacterial resistance urges the scientific community to implement intervention programs in healthcare facilities to promote an appropriate use of antibiotics. However, the clinical benefits or the impact on resistance of these interventions has not been definitively proved.Methods. We designed a quasi-experimental intervention study with an interrupted time-series analysis. A multidisciplinary team conducted a multifaceted educational intervention in our tertiary-care hospital over a 5-year period. The main activity of the program consisted of peer-to-peer educational interviews between counselors and prescribers from all departments to reinforce the principles of the proper use of antibiotics. We assessed antibiotic consumption, incidence density of Candida and multidrug-resistant (MDR) bacteria bloodstream infections (BSIs) and their crude death rate per 1000 occupied bed days (OBDs).Results. A quick and intense reduction in antibiotic consumption occurred 6 months after the implementation of the intervention (change in level, -216.8 defined daily doses per 1000 OBDs; 95% confidence interval, -347.5 to -86.1), and was sustained during subsequent years (average reduction, -19,9%). In addition, the increasing trend observed in the preintervention period for the incidence density of candidemia and MDR BSI (+0.018 cases per 1000 OBDs per quarter; 95% confidence interval, -.003 to.039) reverted toward a decreasing trend of -0.130 per quarter (change in slope, -0.029; -.051 to -.008), and so did the mortality rate (change in slope, -0.015;-.021 to -.008).Conclusions. This education-based antimicrobial stewardship program was effective in decreasing the incidence and mortality rate of hospital-acquired candidemia and MDR BSI through sustained reduction in antibiotic use.
PB Oxford univ press inc
SN 1058-4838
YR 2017
FD 2017-12-15
LK http://hdl.handle.net/10668/18941
UL http://hdl.handle.net/10668/18941
LA en
DS RISalud
RD Apr 9, 2025