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Impact of Antibiotic Authorisation at Three Provincial Hospitals in Thailand: Results from a Quasi-Experimental Study

Implementing antimicrobial stewardship (AMS) at non-university hospitals is challenging. A quasi-experimental study was conducted to determine the impact of customised antibiotic authorisation implementation on antimicrobial consumption and clinical outcomes at three provincial hospitals in Thailand...

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Autores principales: Wangchinda, Walaiporn, Srisompong, Jintana, Chayangsu, Sunee, Ruangkriengsin, Darat, Thamlikitkul, Visanu, Koomanachai, Pornpan, Sirijatuphat, Rujipas, Rattanaumpawan, Pinyo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8944558/
https://www.ncbi.nlm.nih.gov/pubmed/35326817
http://dx.doi.org/10.3390/antibiotics11030354
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author Wangchinda, Walaiporn
Srisompong, Jintana
Chayangsu, Sunee
Ruangkriengsin, Darat
Thamlikitkul, Visanu
Koomanachai, Pornpan
Sirijatuphat, Rujipas
Rattanaumpawan, Pinyo
author_facet Wangchinda, Walaiporn
Srisompong, Jintana
Chayangsu, Sunee
Ruangkriengsin, Darat
Thamlikitkul, Visanu
Koomanachai, Pornpan
Sirijatuphat, Rujipas
Rattanaumpawan, Pinyo
author_sort Wangchinda, Walaiporn
collection PubMed
description Implementing antimicrobial stewardship (AMS) at non-university hospitals is challenging. A quasi-experimental study was conducted to determine the impact of customised antibiotic authorisation implementation on antimicrobial consumption and clinical outcomes at three provincial hospitals in Thailand. Customised pre-authorisation of selected restricted antibiotics and post-authorisation of selected controlled antibiotics were undertaken and implemented at each hospital by the local AMS team with guidance from the AMS team at the university hospital. From January 2019–December 2020, there were 1802 selected patients (901 patients during the pre-implementation period and 901 patients during the post-implementation period). The most commonly used targeted antimicrobial was meropenem (49.61%), followed by piperacillin/tazobactam (36.46%). Comparison of the outcomes of the patients during the pre- and post-implementation periods revealed that the mean day of therapy of the targeted antimicrobials was significantly shorter during the post-implementation period (6.24 vs. 7.64 days; p < 0.001), the favourable clinical response (the improvement in all clinical and laboratory parameters at the end of antibiotic therapy) was significantly higher during the post-implementation period (72.70% vs. 68.04%; p = 0.03) and the mean length of hospital stay was significantly shorter during the post-implementation period (15.78 vs. 18.90 days; p < 0.001). In conclusion, implementation of antibiotic authorisation at provincial hospitals under experienced AMS team’s guidance was feasible and useful. The study results could be a good model for the implementation of customised AMS strategies at other hospitals with limited resources.
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spelling pubmed-89445582022-03-25 Impact of Antibiotic Authorisation at Three Provincial Hospitals in Thailand: Results from a Quasi-Experimental Study Wangchinda, Walaiporn Srisompong, Jintana Chayangsu, Sunee Ruangkriengsin, Darat Thamlikitkul, Visanu Koomanachai, Pornpan Sirijatuphat, Rujipas Rattanaumpawan, Pinyo Antibiotics (Basel) Article Implementing antimicrobial stewardship (AMS) at non-university hospitals is challenging. A quasi-experimental study was conducted to determine the impact of customised antibiotic authorisation implementation on antimicrobial consumption and clinical outcomes at three provincial hospitals in Thailand. Customised pre-authorisation of selected restricted antibiotics and post-authorisation of selected controlled antibiotics were undertaken and implemented at each hospital by the local AMS team with guidance from the AMS team at the university hospital. From January 2019–December 2020, there were 1802 selected patients (901 patients during the pre-implementation period and 901 patients during the post-implementation period). The most commonly used targeted antimicrobial was meropenem (49.61%), followed by piperacillin/tazobactam (36.46%). Comparison of the outcomes of the patients during the pre- and post-implementation periods revealed that the mean day of therapy of the targeted antimicrobials was significantly shorter during the post-implementation period (6.24 vs. 7.64 days; p < 0.001), the favourable clinical response (the improvement in all clinical and laboratory parameters at the end of antibiotic therapy) was significantly higher during the post-implementation period (72.70% vs. 68.04%; p = 0.03) and the mean length of hospital stay was significantly shorter during the post-implementation period (15.78 vs. 18.90 days; p < 0.001). In conclusion, implementation of antibiotic authorisation at provincial hospitals under experienced AMS team’s guidance was feasible and useful. The study results could be a good model for the implementation of customised AMS strategies at other hospitals with limited resources. MDPI 2022-03-07 /pmc/articles/PMC8944558/ /pubmed/35326817 http://dx.doi.org/10.3390/antibiotics11030354 Text en © 2022 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
Wangchinda, Walaiporn
Srisompong, Jintana
Chayangsu, Sunee
Ruangkriengsin, Darat
Thamlikitkul, Visanu
Koomanachai, Pornpan
Sirijatuphat, Rujipas
Rattanaumpawan, Pinyo
Impact of Antibiotic Authorisation at Three Provincial Hospitals in Thailand: Results from a Quasi-Experimental Study
title Impact of Antibiotic Authorisation at Three Provincial Hospitals in Thailand: Results from a Quasi-Experimental Study
title_full Impact of Antibiotic Authorisation at Three Provincial Hospitals in Thailand: Results from a Quasi-Experimental Study
title_fullStr Impact of Antibiotic Authorisation at Three Provincial Hospitals in Thailand: Results from a Quasi-Experimental Study
title_full_unstemmed Impact of Antibiotic Authorisation at Three Provincial Hospitals in Thailand: Results from a Quasi-Experimental Study
title_short Impact of Antibiotic Authorisation at Three Provincial Hospitals in Thailand: Results from a Quasi-Experimental Study
title_sort impact of antibiotic authorisation at three provincial hospitals in thailand: results from a quasi-experimental study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8944558/
https://www.ncbi.nlm.nih.gov/pubmed/35326817
http://dx.doi.org/10.3390/antibiotics11030354
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