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Effectiveness and Acceptance of Multimodal Antibiotic Stewardship Program: Considering Progressive Implementation and Complementary Strategies

Multiple modes of interventions are available when implementing an antibiotic stewardship program (ASP), however, their complementarity has not yet been assessed. In a 938-bed hospital, we sequentially implemented four combined modes of interventions over one year, centralized by one infectious dise...

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Autores principales: Bouchet, Flavien, Le Moing, Vincent, Dirand, Delphine, Cros, François, Lienard, Alexi, Reynes, Jacques, Giraudon, Laurent, Morquin, David
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7760905/
https://www.ncbi.nlm.nih.gov/pubmed/33260815
http://dx.doi.org/10.3390/antibiotics9120848
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author Bouchet, Flavien
Le Moing, Vincent
Dirand, Delphine
Cros, François
Lienard, Alexi
Reynes, Jacques
Giraudon, Laurent
Morquin, David
author_facet Bouchet, Flavien
Le Moing, Vincent
Dirand, Delphine
Cros, François
Lienard, Alexi
Reynes, Jacques
Giraudon, Laurent
Morquin, David
author_sort Bouchet, Flavien
collection PubMed
description Multiple modes of interventions are available when implementing an antibiotic stewardship program (ASP), however, their complementarity has not yet been assessed. In a 938-bed hospital, we sequentially implemented four combined modes of interventions over one year, centralized by one infectious diseases specialist (IDS): (1) on-request infectious diseases specialist consulting service (IDSCS), (2) participation in intensive care unit meetings, (3) IDS intervention triggered by microbiological laboratory meetings, and (4) IDS intervention triggered by pharmacist alert. We assessed the complementarity of the different cumulative actions through quantitative and qualitative analysis of all interventions traced in the electronic medical record. We observed a quantitative and qualitative complementarity between interventions directly correlating to a decrease in antibiotic use. Quantitatively, the number of interventions has doubled after implementation of IDS intervention triggered by pharmacist alert. Qualitatively, these kinds of interventions led mainly to de-escalation or stopping of antibiotic therapy (63%) as opposed to on-request IDSCS (32%). An overall decrease of 14.6% in antibiotic use was observed (p = 0.03). Progressive implementation of the different interventions showed a concrete complementarity of these actions. Combined actions in ASPs could lead to a significant decrease in antibiotic use, especially regarding critical antibiotic prescriptions, while being well accepted by prescribers.
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spelling pubmed-77609052020-12-26 Effectiveness and Acceptance of Multimodal Antibiotic Stewardship Program: Considering Progressive Implementation and Complementary Strategies Bouchet, Flavien Le Moing, Vincent Dirand, Delphine Cros, François Lienard, Alexi Reynes, Jacques Giraudon, Laurent Morquin, David Antibiotics (Basel) Article Multiple modes of interventions are available when implementing an antibiotic stewardship program (ASP), however, their complementarity has not yet been assessed. In a 938-bed hospital, we sequentially implemented four combined modes of interventions over one year, centralized by one infectious diseases specialist (IDS): (1) on-request infectious diseases specialist consulting service (IDSCS), (2) participation in intensive care unit meetings, (3) IDS intervention triggered by microbiological laboratory meetings, and (4) IDS intervention triggered by pharmacist alert. We assessed the complementarity of the different cumulative actions through quantitative and qualitative analysis of all interventions traced in the electronic medical record. We observed a quantitative and qualitative complementarity between interventions directly correlating to a decrease in antibiotic use. Quantitatively, the number of interventions has doubled after implementation of IDS intervention triggered by pharmacist alert. Qualitatively, these kinds of interventions led mainly to de-escalation or stopping of antibiotic therapy (63%) as opposed to on-request IDSCS (32%). An overall decrease of 14.6% in antibiotic use was observed (p = 0.03). Progressive implementation of the different interventions showed a concrete complementarity of these actions. Combined actions in ASPs could lead to a significant decrease in antibiotic use, especially regarding critical antibiotic prescriptions, while being well accepted by prescribers. MDPI 2020-11-27 /pmc/articles/PMC7760905/ /pubmed/33260815 http://dx.doi.org/10.3390/antibiotics9120848 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 Article
Bouchet, Flavien
Le Moing, Vincent
Dirand, Delphine
Cros, François
Lienard, Alexi
Reynes, Jacques
Giraudon, Laurent
Morquin, David
Effectiveness and Acceptance of Multimodal Antibiotic Stewardship Program: Considering Progressive Implementation and Complementary Strategies
title Effectiveness and Acceptance of Multimodal Antibiotic Stewardship Program: Considering Progressive Implementation and Complementary Strategies
title_full Effectiveness and Acceptance of Multimodal Antibiotic Stewardship Program: Considering Progressive Implementation and Complementary Strategies
title_fullStr Effectiveness and Acceptance of Multimodal Antibiotic Stewardship Program: Considering Progressive Implementation and Complementary Strategies
title_full_unstemmed Effectiveness and Acceptance of Multimodal Antibiotic Stewardship Program: Considering Progressive Implementation and Complementary Strategies
title_short Effectiveness and Acceptance of Multimodal Antibiotic Stewardship Program: Considering Progressive Implementation and Complementary Strategies
title_sort effectiveness and acceptance of multimodal antibiotic stewardship program: considering progressive implementation and complementary strategies
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7760905/
https://www.ncbi.nlm.nih.gov/pubmed/33260815
http://dx.doi.org/10.3390/antibiotics9120848
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