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Effectiveness of a Multifaced Antibiotic Stewardship Program: A Pre-Post Study in Seven Italian ICUs
Multidrug resistance has become a serious threat for health, particularly in hospital-acquired infections. To improve patients’ safety and outcomes while maintaining the efficacy of antimicrobials, complex interventions are needed involving infection control and appropriate pharmacological treatment...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9369193/ https://www.ncbi.nlm.nih.gov/pubmed/35956026 http://dx.doi.org/10.3390/jcm11154409 |
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author | Mandelli, Giulia Dore, Francesca Langer, Martin Garbero, Elena Alagna, Laura Bianchin, Andrea Ciceri, Rita Di Paolo, Antonello Giani, Tommaso Giugni, Aimone Gori, Andrea Lefons, Ugo Muscatello, Antonio Olivieri, Carlo Pan, Angelo Pedeferri, Matteo Rossi, Marianna Rossolini, Gian Maria Russo, Emanuele Silengo, Daniela Viaggi, Bruno Bertolini, Guido Finazzi, Stefano |
author_facet | Mandelli, Giulia Dore, Francesca Langer, Martin Garbero, Elena Alagna, Laura Bianchin, Andrea Ciceri, Rita Di Paolo, Antonello Giani, Tommaso Giugni, Aimone Gori, Andrea Lefons, Ugo Muscatello, Antonio Olivieri, Carlo Pan, Angelo Pedeferri, Matteo Rossi, Marianna Rossolini, Gian Maria Russo, Emanuele Silengo, Daniela Viaggi, Bruno Bertolini, Guido Finazzi, Stefano |
author_sort | Mandelli, Giulia |
collection | PubMed |
description | Multidrug resistance has become a serious threat for health, particularly in hospital-acquired infections. To improve patients’ safety and outcomes while maintaining the efficacy of antimicrobials, complex interventions are needed involving infection control and appropriate pharmacological treatments in antibiotic stewardship programs. We conducted a multicenter pre-post study to assess the impact of a stewardship program in seven Italian intensive care units (ICUs). Each ICU was visited by a multidisciplinary team involving clinicians, microbiologists, pharmacologists, infectious disease specialists, and data scientists. Interventions were targeted according to the characteristics of each unit. The effect of the program was measured with a panel of indicators computed with data from the MargheritaTre electronic health record. The median duration of empirical therapy decreased from 5.6 to 4.6 days and the use of quinolones dropped from 15.3% to 6%, both p < 0.001. The proportion of multi-drug-resistant bacteria (MDR) in ICU-acquired infections fell from 57.7% to 48.8%. ICU mortality and length of stay remained unchanged, indicating that reducing antibiotic administration did not harm patients’ safety. This study shows that our stewardship program successfully improved the management of infections. This suggests that policy makers should tackle multidrug resistance with a multidisciplinary approach based on continuous monitoring and personalised interventions. |
format | Online Article Text |
id | pubmed-9369193 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-93691932022-08-12 Effectiveness of a Multifaced Antibiotic Stewardship Program: A Pre-Post Study in Seven Italian ICUs Mandelli, Giulia Dore, Francesca Langer, Martin Garbero, Elena Alagna, Laura Bianchin, Andrea Ciceri, Rita Di Paolo, Antonello Giani, Tommaso Giugni, Aimone Gori, Andrea Lefons, Ugo Muscatello, Antonio Olivieri, Carlo Pan, Angelo Pedeferri, Matteo Rossi, Marianna Rossolini, Gian Maria Russo, Emanuele Silengo, Daniela Viaggi, Bruno Bertolini, Guido Finazzi, Stefano J Clin Med Article Multidrug resistance has become a serious threat for health, particularly in hospital-acquired infections. To improve patients’ safety and outcomes while maintaining the efficacy of antimicrobials, complex interventions are needed involving infection control and appropriate pharmacological treatments in antibiotic stewardship programs. We conducted a multicenter pre-post study to assess the impact of a stewardship program in seven Italian intensive care units (ICUs). Each ICU was visited by a multidisciplinary team involving clinicians, microbiologists, pharmacologists, infectious disease specialists, and data scientists. Interventions were targeted according to the characteristics of each unit. The effect of the program was measured with a panel of indicators computed with data from the MargheritaTre electronic health record. The median duration of empirical therapy decreased from 5.6 to 4.6 days and the use of quinolones dropped from 15.3% to 6%, both p < 0.001. The proportion of multi-drug-resistant bacteria (MDR) in ICU-acquired infections fell from 57.7% to 48.8%. ICU mortality and length of stay remained unchanged, indicating that reducing antibiotic administration did not harm patients’ safety. This study shows that our stewardship program successfully improved the management of infections. This suggests that policy makers should tackle multidrug resistance with a multidisciplinary approach based on continuous monitoring and personalised interventions. MDPI 2022-07-28 /pmc/articles/PMC9369193/ /pubmed/35956026 http://dx.doi.org/10.3390/jcm11154409 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 Mandelli, Giulia Dore, Francesca Langer, Martin Garbero, Elena Alagna, Laura Bianchin, Andrea Ciceri, Rita Di Paolo, Antonello Giani, Tommaso Giugni, Aimone Gori, Andrea Lefons, Ugo Muscatello, Antonio Olivieri, Carlo Pan, Angelo Pedeferri, Matteo Rossi, Marianna Rossolini, Gian Maria Russo, Emanuele Silengo, Daniela Viaggi, Bruno Bertolini, Guido Finazzi, Stefano Effectiveness of a Multifaced Antibiotic Stewardship Program: A Pre-Post Study in Seven Italian ICUs |
title | Effectiveness of a Multifaced Antibiotic Stewardship Program: A Pre-Post Study in Seven Italian ICUs |
title_full | Effectiveness of a Multifaced Antibiotic Stewardship Program: A Pre-Post Study in Seven Italian ICUs |
title_fullStr | Effectiveness of a Multifaced Antibiotic Stewardship Program: A Pre-Post Study in Seven Italian ICUs |
title_full_unstemmed | Effectiveness of a Multifaced Antibiotic Stewardship Program: A Pre-Post Study in Seven Italian ICUs |
title_short | Effectiveness of a Multifaced Antibiotic Stewardship Program: A Pre-Post Study in Seven Italian ICUs |
title_sort | effectiveness of a multifaced antibiotic stewardship program: a pre-post study in seven italian icus |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9369193/ https://www.ncbi.nlm.nih.gov/pubmed/35956026 http://dx.doi.org/10.3390/jcm11154409 |
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