| Title: | Clinical outcomes of intervention for carbapenems and anti-methicillin-resistant Staphylococcus aureus antibiotics by an antimicrobial stewardship team |
| Authors: | Kagami, Keisuke Browse this author |
| Ishiguro, Nobuhisa Browse this author →KAKEN DB |
| Yamada, Takehiro Browse this author |
| Niinuma, Yusuke Browse this author |
| Iwasaki, Sumio Browse this author |
| Taki, Keisuke Browse this author |
| Fukumoto, Tatsuya Browse this author |
| Hayasaka, Kasumi Browse this author |
| Nishida, Mutsumi Browse this author |
| Sugita, Junichi Browse this author |
| Teshima, Takanori Browse this author |
| Sugawara, Mitsuru Browse this author |
| Takekuma, Yoh Browse this author →KAKEN DB |
| Keywords: | AST |
| ASP |
| Meropenem |
| MRSA |
| Outcome |
| Antibiotic use |
| Issue Date: | Dec-2021 |
| Publisher: | Elsevier |
| Journal Title: | American Journal of Infection Control |
| Volume: | 49 |
| Issue: | 12 |
| Start Page: | 1493 |
| End Page: | 1498 |
| Publisher DOI: | 10.1016/j.ajic.2021.08.011 |
| Abstract: | Background: 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. |
| Rights: | © 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/ |
| http://creativecommons.org/licenses/by-nc-nd/4.0/ |
| Type: | article (author version) |
| URI: | http://hdl.handle.net/2115/87379 |
| Appears in Collections: | 北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
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