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Effectiveness of Antimicrobial Stewardship Program in Long-Term Care: A Five-Year Prospective Single-Center Study

OBJECTIVE: To report the effectiveness of the antimicrobial stewardship program (ASP) in a long-term care (LTC) facility, by analyzing the change in antimicrobial consumption and cost and multidrug resistance (MDR) rates over a 5-year period. METHOD: A prospective interventional study was conducted...

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Autores principales: Alawi, Maha Mahmoud, Tashkandi, Wail A, Basheikh, Mohamed A, Warshan, Faten M, Ghobara, Hazem Ahmed, Ramos, Rosemarie B., Guiriba, Mary Leilani, Ayob, Omar, Janah, Safiah Saad, Sindi, Anees Ahmad, Abdulhamid Ahmed, Suheib Ali, Dammnan, Salah, Azhar, Esam Ibraheem, Rabaan, Ali A., Alnahdi, Salma, Bamahakesh, Maged Mohammed
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9019452/
https://www.ncbi.nlm.nih.gov/pubmed/35464254
http://dx.doi.org/10.1155/2022/8140429
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author Alawi, Maha Mahmoud
Tashkandi, Wail A
Basheikh, Mohamed A
Warshan, Faten M
Ghobara, Hazem Ahmed
Ramos, Rosemarie B.
Guiriba, Mary Leilani
Ayob, Omar
Janah, Safiah Saad
Sindi, Anees Ahmad
Abdulhamid Ahmed, Suheib Ali
Dammnan, Salah
Azhar, Esam Ibraheem
Rabaan, Ali A.
Alnahdi, Salma
Bamahakesh, Maged Mohammed
author_facet Alawi, Maha Mahmoud
Tashkandi, Wail A
Basheikh, Mohamed A
Warshan, Faten M
Ghobara, Hazem Ahmed
Ramos, Rosemarie B.
Guiriba, Mary Leilani
Ayob, Omar
Janah, Safiah Saad
Sindi, Anees Ahmad
Abdulhamid Ahmed, Suheib Ali
Dammnan, Salah
Azhar, Esam Ibraheem
Rabaan, Ali A.
Alnahdi, Salma
Bamahakesh, Maged Mohammed
author_sort Alawi, Maha Mahmoud
collection PubMed
description OBJECTIVE: To report the effectiveness of the antimicrobial stewardship program (ASP) in a long-term care (LTC) facility, by analyzing the change in antimicrobial consumption and cost and multidrug resistance (MDR) rates over a 5-year period. METHOD: A prospective interventional study was conducted at a 106-bed facility (nursing home: 100 beds and an intensive care unit (ICU): 6 beds). The ASP was designed and led by a multidisciplinary team including an infectious disease consultant, two clinical pharmacists, a clinical microbiologist, and an infection control preventionist. Five key performance indicators were monitored: (1) intravenous (IV)-to-oral switch rate, (2) consumption of restricted IV antimicrobials (raw consumption and defined daily doses (DDD) index), (3) cost of restricted IV antimicrobials, (4) antimicrobial sensitivity profiles, and (5) MDR rate among hospital-acquired infections (MDR-HAI). RESULT: A ∼5.5-fold enhancement of the IV-to-oral switch and a 40% reduction in the overall consumption of restricted IV antimicrobials were observed. Regarding the cost, the cumulative cost saving was estimated as 5.64 million SAR (US$1.50 million). Microbiologically, no significant change in antimicrobial sensitivity profiles was observed; however, a large-size reduction in the MDR-HAI rate was observed, notably in ICU where it declined from 3.22 per 1,000 patient days, in 2015, to 1.14 per 1,000 patient days in 2020. Interestingly, the yearly overall MDR rate was strongly correlated with the level of antimicrobial consumption. CONCLUSION: The implementation of a multidisciplinary ASP in LTC facilities should be further encouraged, with emphasis on physicians' education and active involvement to enhance the success of the strategy.
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spelling pubmed-90194522022-04-21 Effectiveness of Antimicrobial Stewardship Program in Long-Term Care: A Five-Year Prospective Single-Center Study Alawi, Maha Mahmoud Tashkandi, Wail A Basheikh, Mohamed A Warshan, Faten M Ghobara, Hazem Ahmed Ramos, Rosemarie B. Guiriba, Mary Leilani Ayob, Omar Janah, Safiah Saad Sindi, Anees Ahmad Abdulhamid Ahmed, Suheib Ali Dammnan, Salah Azhar, Esam Ibraheem Rabaan, Ali A. Alnahdi, Salma Bamahakesh, Maged Mohammed Interdiscip Perspect Infect Dis Research Article OBJECTIVE: To report the effectiveness of the antimicrobial stewardship program (ASP) in a long-term care (LTC) facility, by analyzing the change in antimicrobial consumption and cost and multidrug resistance (MDR) rates over a 5-year period. METHOD: A prospective interventional study was conducted at a 106-bed facility (nursing home: 100 beds and an intensive care unit (ICU): 6 beds). The ASP was designed and led by a multidisciplinary team including an infectious disease consultant, two clinical pharmacists, a clinical microbiologist, and an infection control preventionist. Five key performance indicators were monitored: (1) intravenous (IV)-to-oral switch rate, (2) consumption of restricted IV antimicrobials (raw consumption and defined daily doses (DDD) index), (3) cost of restricted IV antimicrobials, (4) antimicrobial sensitivity profiles, and (5) MDR rate among hospital-acquired infections (MDR-HAI). RESULT: A ∼5.5-fold enhancement of the IV-to-oral switch and a 40% reduction in the overall consumption of restricted IV antimicrobials were observed. Regarding the cost, the cumulative cost saving was estimated as 5.64 million SAR (US$1.50 million). Microbiologically, no significant change in antimicrobial sensitivity profiles was observed; however, a large-size reduction in the MDR-HAI rate was observed, notably in ICU where it declined from 3.22 per 1,000 patient days, in 2015, to 1.14 per 1,000 patient days in 2020. Interestingly, the yearly overall MDR rate was strongly correlated with the level of antimicrobial consumption. CONCLUSION: The implementation of a multidisciplinary ASP in LTC facilities should be further encouraged, with emphasis on physicians' education and active involvement to enhance the success of the strategy. Hindawi 2022-04-12 /pmc/articles/PMC9019452/ /pubmed/35464254 http://dx.doi.org/10.1155/2022/8140429 Text en Copyright © 2022 Maha Mahmoud Alawi et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Alawi, Maha Mahmoud
Tashkandi, Wail A
Basheikh, Mohamed A
Warshan, Faten M
Ghobara, Hazem Ahmed
Ramos, Rosemarie B.
Guiriba, Mary Leilani
Ayob, Omar
Janah, Safiah Saad
Sindi, Anees Ahmad
Abdulhamid Ahmed, Suheib Ali
Dammnan, Salah
Azhar, Esam Ibraheem
Rabaan, Ali A.
Alnahdi, Salma
Bamahakesh, Maged Mohammed
Effectiveness of Antimicrobial Stewardship Program in Long-Term Care: A Five-Year Prospective Single-Center Study
title Effectiveness of Antimicrobial Stewardship Program in Long-Term Care: A Five-Year Prospective Single-Center Study
title_full Effectiveness of Antimicrobial Stewardship Program in Long-Term Care: A Five-Year Prospective Single-Center Study
title_fullStr Effectiveness of Antimicrobial Stewardship Program in Long-Term Care: A Five-Year Prospective Single-Center Study
title_full_unstemmed Effectiveness of Antimicrobial Stewardship Program in Long-Term Care: A Five-Year Prospective Single-Center Study
title_short Effectiveness of Antimicrobial Stewardship Program in Long-Term Care: A Five-Year Prospective Single-Center Study
title_sort effectiveness of antimicrobial stewardship program in long-term care: a five-year prospective single-center study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9019452/
https://www.ncbi.nlm.nih.gov/pubmed/35464254
http://dx.doi.org/10.1155/2022/8140429
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