2024-03-29T10:50:11Zhttps://eprints.lib.hokudai.ac.jp/dspace-oai/requestoai:eprints.lib.hokudai.ac.jp:2115/873792022-12-02T17:14:44Zhdl_2115_20043hdl_2115_137Clinical outcomes of intervention for carbapenems and anti-methicillin-resistant Staphylococcus aureus antibiotics by an antimicrobial stewardship teamKagami, Keisuke1000040168216Ishiguro, NobuhisaYamada, TakehiroNiinuma, YusukeIwasaki, SumioTaki, KeisukeFukumoto, TatsuyaHayasaka, KasumiNishida, MutsumiSugita, JunichiTeshima, TakanoriSugawara, Mitsuru1000000396293Takekuma, Yohopen access© 2021. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 InternationalASTASPMeropenemMRSAOutcomeAntibiotic use490Background: There are no reports on the effects of interventions, such as discontinuation and change and/or deescalation of carbapenems and anti-methicillin-resistant Staphylococcus aureus (MRSA) antibiotics by an antimicrobial stewardship team focusing on detailed patient outcomes. This study aimed to evaluate these effects. Methods: This retrospective cohort study was conducted at a tertiary care hospital from December 2018 to November 2019. Results: Favorable clinical responses were obtained in 165 of 184 cases (89.7%) in the intervention-accepted group, higher than those in the not accepted group (14/19 cases, 73.7%; P = .056). All-cause 30 day mortality was lower in the accepted group than in the not accepted group (1.1% and 10.5%, respectively; P = .045). The microbiological outcomes were similar between the two groups. Duration of carbapenem and anti-MRSA antibiotic use in the accepted group was significantly lower than that in the not accepted group (median [interquartile range]: 8 days [5-13] versus 14 days [8-15], respectively, P = .026 for carbapenem; 10 days [5.3-15] vs 15.5 days [13.8-45.3], respectively, P = .014 for anti-MRSA antibiotic). Conclusions: This is the first study to investigate the effects of interventions such as discontinuation and change and/ or de-escalation of antibiotics on detailed outcomes. Our intervention could reduce the duration of carbapenem and anti-MRSA antibiotic use without worsening clinical and microbiological outcomes. (c) 2021 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.Elsevier2021-12engjournal articleAMhttp://hdl.handle.net/2115/87379https://doi.org/10.1016/j.ajic.2021.08.0110196-6553American Journal of Infection Control491214931498https://eprints.lib.hokudai.ac.jp/dspace/bitstream/2115/87379/1/Kagami%20K%20et%20al.%20%20Am.%20J.%20Infect.%20Control%2049%2c%201493-8%2c%202021.pdfapplication/pdf334.75 KB2021-12