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Impact of a Diagnosis-Centered Antibiotic Stewardship on Incident Clostridioides difficile Infections in Older Inpatients: An Observational Study

In 2015, a major increase in incident hospital-onset Clostridioides difficile infections (HO-CDI) in a geriatric university hospital led to the implementation of a diagnosis-centered antibiotic stewardship program (ASP). We aimed to evaluate the impact of the ASP on antibiotic consumption and on HO-...

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Autores principales: Putot, Alain, Astruc, Karine, Barben, Jeremy, Mihai, Anca Maria, Nuss, Valentine, Bador, Julien, Putot, Sophie, Dipanda, Mélanie, Laborde, Caroline, Vovelle, Jeremie, Da Silva, Sofia, Mazen, Emmanuel, Aho Glélé, Ludwig Serge, Manckoundia, Patrick
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7345193/
https://www.ncbi.nlm.nih.gov/pubmed/32517086
http://dx.doi.org/10.3390/antibiotics9060303
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author Putot, Alain
Astruc, Karine
Barben, Jeremy
Mihai, Anca Maria
Nuss, Valentine
Bador, Julien
Putot, Sophie
Dipanda, Mélanie
Laborde, Caroline
Vovelle, Jeremie
Da Silva, Sofia
Mazen, Emmanuel
Aho Glélé, Ludwig Serge
Manckoundia, Patrick
author_facet Putot, Alain
Astruc, Karine
Barben, Jeremy
Mihai, Anca Maria
Nuss, Valentine
Bador, Julien
Putot, Sophie
Dipanda, Mélanie
Laborde, Caroline
Vovelle, Jeremie
Da Silva, Sofia
Mazen, Emmanuel
Aho Glélé, Ludwig Serge
Manckoundia, Patrick
author_sort Putot, Alain
collection PubMed
description In 2015, a major increase in incident hospital-onset Clostridioides difficile infections (HO-CDI) in a geriatric university hospital led to the implementation of a diagnosis-centered antibiotic stewardship program (ASP). We aimed to evaluate the impact of the ASP on antibiotic consumption and on HO-CDI incidence. The intervention was the arrival of a full-time infectiologist in the acute geriatric unit in May 2015, followed by the implementation of new diagnostic procedures for infections associated with an antibiotic withdrawal policy. Between 2015 and 2018, the ASP was associated with a major reduction in diagnoses for inpatients (23% to 13% for pneumonia, 24% to 13% for urinary tract infection), while median hospital stays and mortality rates remained stable. The reduction in diagnosed bacterial infections was associated with a 45% decrease in antibiotic consumption in the acute geriatric unit. HO-CDI incidence also decreased dramatically from 1.4‰ bed-days to 0.8‰ bed-days in the geriatric rehabilitation unit. The ASP focused on reducing the overdiagnosis of bacterial infections in the acute geriatric unit was successfully associated with both a reduction in antibiotic use and a clear reduction in the incidence of HO-CDI in the geriatric rehabilitation unit.
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spelling pubmed-73451932020-07-09 Impact of a Diagnosis-Centered Antibiotic Stewardship on Incident Clostridioides difficile Infections in Older Inpatients: An Observational Study Putot, Alain Astruc, Karine Barben, Jeremy Mihai, Anca Maria Nuss, Valentine Bador, Julien Putot, Sophie Dipanda, Mélanie Laborde, Caroline Vovelle, Jeremie Da Silva, Sofia Mazen, Emmanuel Aho Glélé, Ludwig Serge Manckoundia, Patrick Antibiotics (Basel) Brief Report In 2015, a major increase in incident hospital-onset Clostridioides difficile infections (HO-CDI) in a geriatric university hospital led to the implementation of a diagnosis-centered antibiotic stewardship program (ASP). We aimed to evaluate the impact of the ASP on antibiotic consumption and on HO-CDI incidence. The intervention was the arrival of a full-time infectiologist in the acute geriatric unit in May 2015, followed by the implementation of new diagnostic procedures for infections associated with an antibiotic withdrawal policy. Between 2015 and 2018, the ASP was associated with a major reduction in diagnoses for inpatients (23% to 13% for pneumonia, 24% to 13% for urinary tract infection), while median hospital stays and mortality rates remained stable. The reduction in diagnosed bacterial infections was associated with a 45% decrease in antibiotic consumption in the acute geriatric unit. HO-CDI incidence also decreased dramatically from 1.4‰ bed-days to 0.8‰ bed-days in the geriatric rehabilitation unit. The ASP focused on reducing the overdiagnosis of bacterial infections in the acute geriatric unit was successfully associated with both a reduction in antibiotic use and a clear reduction in the incidence of HO-CDI in the geriatric rehabilitation unit. MDPI 2020-06-05 /pmc/articles/PMC7345193/ /pubmed/32517086 http://dx.doi.org/10.3390/antibiotics9060303 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Brief Report
Putot, Alain
Astruc, Karine
Barben, Jeremy
Mihai, Anca Maria
Nuss, Valentine
Bador, Julien
Putot, Sophie
Dipanda, Mélanie
Laborde, Caroline
Vovelle, Jeremie
Da Silva, Sofia
Mazen, Emmanuel
Aho Glélé, Ludwig Serge
Manckoundia, Patrick
Impact of a Diagnosis-Centered Antibiotic Stewardship on Incident Clostridioides difficile Infections in Older Inpatients: An Observational Study
title Impact of a Diagnosis-Centered Antibiotic Stewardship on Incident Clostridioides difficile Infections in Older Inpatients: An Observational Study
title_full Impact of a Diagnosis-Centered Antibiotic Stewardship on Incident Clostridioides difficile Infections in Older Inpatients: An Observational Study
title_fullStr Impact of a Diagnosis-Centered Antibiotic Stewardship on Incident Clostridioides difficile Infections in Older Inpatients: An Observational Study
title_full_unstemmed Impact of a Diagnosis-Centered Antibiotic Stewardship on Incident Clostridioides difficile Infections in Older Inpatients: An Observational Study
title_short Impact of a Diagnosis-Centered Antibiotic Stewardship on Incident Clostridioides difficile Infections in Older Inpatients: An Observational Study
title_sort impact of a diagnosis-centered antibiotic stewardship on incident clostridioides difficile infections in older inpatients: an observational study
topic Brief Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7345193/
https://www.ncbi.nlm.nih.gov/pubmed/32517086
http://dx.doi.org/10.3390/antibiotics9060303
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