A Culture Change: Impact of a Pediatric Antimicrobial Stewardship Program Based on Guideline Implementation and Prospective Audit with Feedback

被引:4
|
作者
Bagga, Bindiya [1 ,2 ]
Stultz, Jeremy S. [2 ,3 ]
Arnold, Sandra [1 ,2 ]
Lee, Kelley R. [2 ,3 ]
机构
[1] Univ Tennessee, Hlth Sci Ctr, Dept Pediat, Div Pediat Infect Dis, Memphis, TN 38163 USA
[2] Le Bonheur Childrens Hosp, Memphis, TN 38103 USA
[3] Univ Tennessee, Hlth Sci Ctr, Dept Clin Pharm & Translat Sci, Memphis, TN 38163 USA
来源
ANTIBIOTICS-BASEL | 2021年 / 10卷 / 11期
关键词
antimicrobial stewardship; pediatric; antimicrobial resistance; antibiotics; sepsis; INFECTIOUS-DISEASES SOCIETY; HEALTH-CARE EPIDEMIOLOGY; ANTIBIOTIC STEWARDSHIP; RESISTANCE; AMERICA;
D O I
10.3390/antibiotics10111307
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Reports analyzing the impact of pediatric antimicrobial stewardship programs (ASP) over long periods of time are lacking. We thus report our ASP experience in a pediatric tertiary referral center over a long-term period from 2011 to 2018. Our ASP was implemented in 2011. The program was based primarily on guideline development with key stakeholders, engaging and educating providers, followed by prospective audit with feedback (PAF). Monitored antibiotics included meropenem, piperacillin-tazobactam, and cefepime, followed by the addition of ceftriaxone, ceftazidime, cefotaxime, ciprofloxacin, levofloxacin, linezolid, and vancomycin at various time points. Specifically, the program did not implemented the core strategy of formulary restriction with prior authorization. Process- and outcome-related ASP measures were analyzed. We saw a 32% decrease in overall antibiotic utilization, a 51% decrease in the utilization of antibiotics undergoing PAF, and a 72% reduction in the use of broad-spectrum antibiotics such as meropenem. There was a concomitant increase in organism susceptibility and a reduction in yearly drug purchasing costs of over USD 560,000 from baseline without changes in sepsis-related mortality. Our study highlights that a pediatric ASP based primarily on the principles of guideline development and PAF can improve antibiotic utilization and institutional bacterial susceptibilities without a detrimental impact on patient outcomes by changing the culture of antimicrobial utilization within the institution.
引用
收藏
页数:8
相关论文
共 50 条
  • [1] Impact of a Prospective-Audit-With-Feedback Antimicrobial Stewardship Program at a Children's Hospital
    Newland, Jason G.
    Stach, Leslie M.
    De Lurgio, Stephen A.
    Hedican, Erin
    Yu, Diana
    Herigon, Joshua C.
    Prasad, Priya A.
    Jackson, Mary Anne
    Myers, Angela L.
    Zaoutis, Theoklis E.
    JOURNAL OF THE PEDIATRIC INFECTIOUS DISEASES SOCIETY, 2012, 1 (03) : 179 - 186
  • [2] Implementation and Perceived Effectiveness of Prospective Audit and Feedback and Preauthorization by US Pediatric Antimicrobial Stewardship Programs
    Manice, Christina S.
    Muralidhar, Nivedita
    Campbell, Jeffrey, I
    Nakamura, Mari M.
    JOURNAL OF THE PEDIATRIC INFECTIOUS DISEASES SOCIETY, 2024, 13 (02) : 117 - 122
  • [3] The implementation and outcome of a 2-year prospective audit and feedback based antimicrobial stewardship program at a private tertiary care hospital
    Thakkar, Pooja
    Singhal, Tanu
    Shah, Sweta
    Bhaysar, Rohit
    Ladi, Shweta
    John, Roshan Elizabeth
    Chavan, Rubina
    Naik, Reshma
    INDIAN JOURNAL OF MEDICAL MICROBIOLOGY, 2021, 39 (04) : 425 - 428
  • [4] Implementation and Suspension of an Antimicrobial Stewardship Audit and Feedback Program: Impact on Antimicrobial Utilization Patterns in an Inpatient General Internal Medicine Unit
    Wong, C.
    Leung, E.
    CANADIAN JOURNAL OF HOSPITAL PHARMACY, 2019, 72 (01): : 86 - 86
  • [5] Impact of a Prospective Audit and Feedback Antimicrobial Stewardship Program at a Veterans Affairs Medical Center: A Six-Point Assessment
    Morrill, Haley J.
    Caffrey, Aisling R.
    Gaitanis, Melissa M.
    LaPlante, Kerry L.
    PLOS ONE, 2016, 11 (03):
  • [6] Comparison of Prior Authorization and Prospective Audit with Feedback for Antimicrobial Stewardship
    Mehta, Jimish M.
    Haynes, Kevin
    Wileyto, E. Paul
    Gerber, Jeffrey S.
    Timko, Daniel R.
    Morgan, Steven C.
    Binkley, Shawn
    Fishman, Neil O.
    Lautenbach, Ebbing
    Zaoutis, Theoklis
    INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY, 2014, 35 (09): : 1092 - 1099
  • [7] In-person prospective audit and feedback on an oncology ward: development of an immunocompromised antimicrobial stewardship program
    Imlay, Hannah
    Greenlee, Sage B.
    Tritle, Brandon J.
    Fino, Nora F.
    Spivak, Emily S.
    ANTIMICROBIAL STEWARDSHIP & HEALTHCARE EPIDEMIOLOGY, 2024, 4 (01):
  • [8] Dynamic online antimicrobial guideline with stewardship program: Impact on antimicrobial prescribing
    Sultana, Syeda Papia
    Rahman, Md. Sayedur
    BANGLADESH JOURNAL OF PHARMACOLOGY, 2017, 12 (04) : 364 - 370
  • [9] Considerations for implementation: Pediatric outpatient antimicrobial stewardship program
    Monsees, Elizabeth A.
    Burns, Alaina N.
    Lee, Brian R.
    Wirtz, Ann
    El Feghaly, Rana E.
    AMERICAN JOURNAL OF INFECTION CONTROL, 2021, 49 (12) : 1543 - 1546
  • [10] High versus low intensity: What is the optimal approach to prospective audit and feedback in an antimicrobial stewardship program?
    Langford, Bradley J.
    Brown, Kevin A.
    Chan, April J.
    Downing, Mark
    INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY, 2019, 40 (12): : 1344 - 1347