Clinical outcomes of intervention for carbapenems and anti-methicillin-resistant Staphylococcus aureus antibiotics by an antimicrobial stewardship team

Kagami, Keisuke; Ishiguro, Nobuhisa; Yamada, Takehiro; Niinuma, Yusuke; Iwasaki, Sumio; Taki, Keisuke; Fukumoto, Tatsuya; Hayasaka, Kasumi; Nishida, Mutsumi; Sugita, Junichi; Teshima, Takanori; Sugawara, Mitsuru; Takekuma, Yoh

Clinical outcomes of intervention for carbapenems and anti-methicillin-resistant Staphylococcus aureus antibiotics by an antimicrobial stewardship team

Kagami, Keisuke; Ishiguro, Nobuhisa; Yamada, Takehiro et al.

American Journal of Infection Control, 2021, 49(12), 1493-1498

Permalink : https://hdl.handle.net/2115/87379

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アクセス権	open access
URI	https://hdl.handle.net/2115/87379
タイトル	Clinical outcomes of intervention for carbapenems and anti-methicillin-resistant Staphylococcus aureus antibiotics by an antimicrobial stewardship team
著者	Kagami, Keisuke ; Ishiguro, Nobuhisa ; Yamada, Takehiro ; Niinuma, Yusuke ; Iwasaki, Sumio ; Taki, Keisuke ; Fukumoto, Tatsuya ; Hayasaka, Kasumi ; Nishida, Mutsumi ; Sugita, Junichi ; Teshima, Takanori ; Sugawara, Mitsuru ; Takekuma, Yoh
著者名 Kagami, Keisuke
e-Rad_Researcher 40168216 著者名 Ishiguro, Nobuhisa
著者名 Yamada, Takehiro
著者名 Niinuma, Yusuke
著者名 Iwasaki, Sumio
著者名 Taki, Keisuke
著者名 Fukumoto, Tatsuya
著者名 Hayasaka, Kasumi
著者名 Nishida, Mutsumi
著者名 Sugita, Junichi
著者名 Teshima, Takanori
著者名 Sugawara, Mitsuru
e-Rad_Researcher 00396293 著者名 Takekuma, Yoh
言語	英語
キーワード	AST
	ASP
	Meropenem
	MRSA
	Outcome
	Antibiotic use
発行日	2021-12
出版者	Elsevier
収録物名	American Journal of Infection Control
巻(号)	49(12)
ページ	1493-1498
抄録	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.
資源タイプ	学術雑誌論文
出版タイプ	Accepted Manuscript
権利情報	Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International
権利情報	© 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/
PISSN	0196-6553
関連情報 (isVersionOf)	出版社版DOI https://doi.org/10.1016/j.ajic.2021.08.011