López-Viñau, TeresaPeñalva, GermánGarcía-Martínez, LucreciaCastón, Juan JoséMuñoz-Rosa, MontserratCano, ÁngelaRecio, ManuelCisneros, José MiguelPérez-Nadales, ElenaRumbao Aguirre, JoséGarcía-Martínez, ElenaSalcedo, InmaculadaDel Prado, José Ramónde la Fuente, CarmenMartínez-Martínez, LuisGracia-Ahufinger, IreneTorre-Cisneros, Julián2022-11-212022-11-212021-05-16López-Viñau T, Peñalva G, García-Martínez L, Castón JJ, Muñoz-Rosa M, Cano Á, et al. Impact of an Antimicrobial Stewardship Program on the Incidence of Carbapenem Resistant Gram-Negative Bacilli: An Interrupted Time-Series Analysis. Antibiotics. 2021 May 16;10(5):586http://hdl.handle.net/10668/4369Carbapenem-resistant Gram-negative bacilli (CR-GNB) are a critical public health threat, and carbapenem use contributes to their spread. Antimicrobial stewardship programs (ASPs) have proven successful in reducing antimicrobial use. However, evidence on the impact of carbapenem resistance remains unclear. We evaluated the impact of a multifaceted ASP on carbapenem use and incidence of CR-GNB in a high-endemic hospital. An interrupted time-series analysis was conducted one year before and two years after starting the ASP to assess carbapenem consumption, CR-GNB incidence, death rates of sentinel events, and other variables potentially related to CR-GNB incidence. An intense reduction in carbapenem consumption occurred after starting the intervention and was sustained two years later (relative effect -83.51%; 95% CI -87.23 to -79.79). The incidence density of CR-GNB decreased by -0.915 cases per 1000 occupied bed days (95% CI -1.743 to -0.087). This effect was especially marked in CR-Klebsiella pneumoniae and CR-Escherichia coli, reversing the pre-intervention upward trend and leading to a relative reduction of -91.15% (95% CI -105.53 to -76.76) and -89.93% (95% CI -107.03 to -72.83), respectively, two years after starting the program. Death rates did not change. This ASP contributed to decreasing CR-GNB incidence through a sustained reduction in antibiotic use without increasing mortality rates.enAtribución 4.0 Internacionalhttp://creativecommons.org/licenses/by/4.0/Antimicrobial stewardship programCarbapenemsAntimicrobial resistanceCarbapenem resistant EnterobacteriaceaeCarbapenemasesProgramas de optimización del uso de los antimicrobianosCarbapenémicosFarmacorresistencia microbianaEnterobacterias resistentes a carbapenémicosKlebsiella pneumoniaeMedical Subject Headings::Organisms::Bacteria::Gram-Negative Bacteria::Gram-Negative Facultatively Anaerobic Rods::Enterobacteriaceae::Klebsiella::Klebsiella pneumoniaeMedical Subject Headings::Information Science::Information Science::Data Collection::Vital Statistics::Morbidity::IncidenceMedical Subject Headings::Health Care::Environment and Public Health::Public HealthMedical Subject Headings::Chemicals and Drugs::Organic Chemicals::Amides::Lactams::beta-Lactams::CarbapenemsMedical Subject Headings::Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Anti-Infective Agents::Anti-Bacterial AgentsMedical Subject Headings::Organisms::Bacteria::Gram-Negative Bacteria::Gram-Negative Facultatively Anaerobic Rods::Enterobacteriaceae::Escherichia::Escherichia coliMedical Subject Headings::Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Anti-Infective AgentsMedical Subject Headings::Health Care::Health Care Facilities, Manpower, and Services::Health Facilities::HospitalsMedical Subject Headings::Health Care::Health Care Quality, Access, and Evaluation::Quality of Health Care::Health Care Evaluation Mechanisms::Statistics as Topic::Regression AnalysisMedical Subject Headings::Chemicals and Drugs::Organic Chemicals::Amides::Lactams::beta-Lactams::CephalosporinsMedical Subject Headings::Chemicals and Drugs::Heterocyclic Compounds::Heterocyclic Compounds, 2-Ring::Quinolinesresearch article34065645open access10.3390/antibiotics100505862079-6382PMC8190633