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The Impact of the SARS-Cov2 Pandemic on a Persuasive Educational Antimicrobial Stewardship Program in a University Hospital in Southern Italy: A Pre-Post Study

Objectives: We evaluated the effect of the pandemic on the disruption of a persuasive educational antimicrobial stewardship program (ASP) conducted in a university hospital in southern Italy. Methods: In March 2020, the ASP, which began in January 2017 and was carried out at different times in 10 wa...

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Autores principales: Macera, Margherita, Onorato, Lorenzo, Calò, Federica, Monari, Caterina, Annibale, Rosa, Signoriello, Giuseppe, Donnarumma, Giovanna, Montemurro, Maria Vittoria, Galdiero, Massimiliano, Coppola, Nicola
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8614883/
https://www.ncbi.nlm.nih.gov/pubmed/34827343
http://dx.doi.org/10.3390/antibiotics10111405
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author Macera, Margherita
Onorato, Lorenzo
Calò, Federica
Monari, Caterina
Annibale, Rosa
Signoriello, Giuseppe
Donnarumma, Giovanna
Montemurro, Maria Vittoria
Galdiero, Massimiliano
Coppola, Nicola
author_facet Macera, Margherita
Onorato, Lorenzo
Calò, Federica
Monari, Caterina
Annibale, Rosa
Signoriello, Giuseppe
Donnarumma, Giovanna
Montemurro, Maria Vittoria
Galdiero, Massimiliano
Coppola, Nicola
author_sort Macera, Margherita
collection PubMed
description Objectives: We evaluated the effect of the pandemic on the disruption of a persuasive educational antimicrobial stewardship program (ASP) conducted in a university hospital in southern Italy. Methods: In March 2020, the ASP, which began in January 2017 and was carried out at different times in 10 wards, was stopped due to the COVID-19 pandemic. We conducted an observational study with interrupted time series analysis to compare the antibiotic consumption and costs, average length of hospital stay and in-hospital mortality between 12 months before and 9 months after the interruption. Results: Four medical, four surgical wards and two ICUs were included in the study, for a total of 35,921 patient days. Among the medical wards we observed after the interruption a significant increase in fluoroquinolone use, with a change in trend (CT) of 0.996, p = 0.027. In the surgical wards, we observed a significant increase in the overall consumption, with a change in level (CL) of 24.4, p = 0.005, and in the use of third and fourth generation cephalosporins (CL 4.7, p = 0.003). In two ICUs, we observed a significant increase in piperacillin/tazobactam and fluoroquinolone consumption (CT 9.28, p = 0.019, and 2.4, p = 0.047). In the wards with a duration of ASP less than 30 months, we observed a significant increase in antibiotic consumption in the use of piperacillin/tazobactam and fluoroquinolones (CT 12.9, p = 0.022: 4.12, p = 0.029; 1.004, p = 0.011). Conclusions: The interruption of ASP during COVID-19 led to an increase in the consumption of broad-spectrum antibiotics, particularly in surgical wards and in those with a duration of ASP less than 30 months.
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spelling pubmed-86148832021-11-26 The Impact of the SARS-Cov2 Pandemic on a Persuasive Educational Antimicrobial Stewardship Program in a University Hospital in Southern Italy: A Pre-Post Study Macera, Margherita Onorato, Lorenzo Calò, Federica Monari, Caterina Annibale, Rosa Signoriello, Giuseppe Donnarumma, Giovanna Montemurro, Maria Vittoria Galdiero, Massimiliano Coppola, Nicola Antibiotics (Basel) Article Objectives: We evaluated the effect of the pandemic on the disruption of a persuasive educational antimicrobial stewardship program (ASP) conducted in a university hospital in southern Italy. Methods: In March 2020, the ASP, which began in January 2017 and was carried out at different times in 10 wards, was stopped due to the COVID-19 pandemic. We conducted an observational study with interrupted time series analysis to compare the antibiotic consumption and costs, average length of hospital stay and in-hospital mortality between 12 months before and 9 months after the interruption. Results: Four medical, four surgical wards and two ICUs were included in the study, for a total of 35,921 patient days. Among the medical wards we observed after the interruption a significant increase in fluoroquinolone use, with a change in trend (CT) of 0.996, p = 0.027. In the surgical wards, we observed a significant increase in the overall consumption, with a change in level (CL) of 24.4, p = 0.005, and in the use of third and fourth generation cephalosporins (CL 4.7, p = 0.003). In two ICUs, we observed a significant increase in piperacillin/tazobactam and fluoroquinolone consumption (CT 9.28, p = 0.019, and 2.4, p = 0.047). In the wards with a duration of ASP less than 30 months, we observed a significant increase in antibiotic consumption in the use of piperacillin/tazobactam and fluoroquinolones (CT 12.9, p = 0.022: 4.12, p = 0.029; 1.004, p = 0.011). Conclusions: The interruption of ASP during COVID-19 led to an increase in the consumption of broad-spectrum antibiotics, particularly in surgical wards and in those with a duration of ASP less than 30 months. MDPI 2021-11-16 /pmc/articles/PMC8614883/ /pubmed/34827343 http://dx.doi.org/10.3390/antibiotics10111405 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/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 (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Macera, Margherita
Onorato, Lorenzo
Calò, Federica
Monari, Caterina
Annibale, Rosa
Signoriello, Giuseppe
Donnarumma, Giovanna
Montemurro, Maria Vittoria
Galdiero, Massimiliano
Coppola, Nicola
The Impact of the SARS-Cov2 Pandemic on a Persuasive Educational Antimicrobial Stewardship Program in a University Hospital in Southern Italy: A Pre-Post Study
title The Impact of the SARS-Cov2 Pandemic on a Persuasive Educational Antimicrobial Stewardship Program in a University Hospital in Southern Italy: A Pre-Post Study
title_full The Impact of the SARS-Cov2 Pandemic on a Persuasive Educational Antimicrobial Stewardship Program in a University Hospital in Southern Italy: A Pre-Post Study
title_fullStr The Impact of the SARS-Cov2 Pandemic on a Persuasive Educational Antimicrobial Stewardship Program in a University Hospital in Southern Italy: A Pre-Post Study
title_full_unstemmed The Impact of the SARS-Cov2 Pandemic on a Persuasive Educational Antimicrobial Stewardship Program in a University Hospital in Southern Italy: A Pre-Post Study
title_short The Impact of the SARS-Cov2 Pandemic on a Persuasive Educational Antimicrobial Stewardship Program in a University Hospital in Southern Italy: A Pre-Post Study
title_sort impact of the sars-cov2 pandemic on a persuasive educational antimicrobial stewardship program in a university hospital in southern italy: a pre-post study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8614883/
https://www.ncbi.nlm.nih.gov/pubmed/34827343
http://dx.doi.org/10.3390/antibiotics10111405
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