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Antimicrobial Stewardship Program for Patients in the Hematological Department Receiving Carbapenem Therapy: A Single-Center and Interrupted Time Series Analysis

As antibiotic resistance has become a global problem, the intervention of an antimicrobial stewardship team (AST) is warranted. In hematological disorders, infectious complications are crucial owing to abnormal neutrophil function and decreased cell-mediated immunity. Despite the widespread implemen...

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Autores principales: Suzuki, Ayako, Yamaguchi, Fumihiro, Maeda, Masayuki, Hashiguchi, Miyuki, Kabasawa, Nobuyuki, Sasaki, Jun, Sato, Tokutada, Fuyama, Masaki, Yamazaki, Yohei, Endo, Kei, Iwata, Kae, Kobayashi, Sei, Fujihara, Hisato
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9951935/
https://www.ncbi.nlm.nih.gov/pubmed/36830213
http://dx.doi.org/10.3390/antibiotics12020302
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author Suzuki, Ayako
Yamaguchi, Fumihiro
Maeda, Masayuki
Hashiguchi, Miyuki
Kabasawa, Nobuyuki
Sasaki, Jun
Sato, Tokutada
Fuyama, Masaki
Yamazaki, Yohei
Endo, Kei
Iwata, Kae
Kobayashi, Sei
Fujihara, Hisato
author_facet Suzuki, Ayako
Yamaguchi, Fumihiro
Maeda, Masayuki
Hashiguchi, Miyuki
Kabasawa, Nobuyuki
Sasaki, Jun
Sato, Tokutada
Fuyama, Masaki
Yamazaki, Yohei
Endo, Kei
Iwata, Kae
Kobayashi, Sei
Fujihara, Hisato
author_sort Suzuki, Ayako
collection PubMed
description As antibiotic resistance has become a global problem, the intervention of an antimicrobial stewardship team (AST) is warranted. In hematological disorders, infectious complications are crucial owing to abnormal neutrophil function and decreased cell-mediated immunity. Despite the widespread implementation of AST intervention, the effectiveness of stewardship practices for immunocompromised patients remains uncertain. We determined the effect of AST interventions on carbapenem therapy in the department of hematology. Patients admitted to the department and undergoing carbapenem therapy were enrolled. We compared carbapenem use between the pre-AST (April 2016–March 2018) and post-AST (April 2018–March 2021) periods. Factors associated with long-term carbapenem therapy were investigated. Overall, 515 episodes of carbapenem therapy in 264 patients in the department were evaluated. According to the interrupted time series analysis, the number of days of therapy decreased with AST intervention (β = −0.263, p = 0.011). In multivariate analysis, predictive factors associated with long-term carbapenem therapy (>8 days) were outpatient onset, chronic obstructive pulmonary disease, acute myeloid leukemia, multiple myeloma, and infection with resistant bacteria (such as extended spectrum β-lactamases and AmpC) (95% confidence interval, 1.030–2.818, 1.067–66.667, 1.057–2.782, 0.168–0.742, and 1.382–5.750, respectively). The AST intervention reduced carbapenem use in patients with hematological disorders.
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spelling pubmed-99519352023-02-25 Antimicrobial Stewardship Program for Patients in the Hematological Department Receiving Carbapenem Therapy: A Single-Center and Interrupted Time Series Analysis Suzuki, Ayako Yamaguchi, Fumihiro Maeda, Masayuki Hashiguchi, Miyuki Kabasawa, Nobuyuki Sasaki, Jun Sato, Tokutada Fuyama, Masaki Yamazaki, Yohei Endo, Kei Iwata, Kae Kobayashi, Sei Fujihara, Hisato Antibiotics (Basel) Article As antibiotic resistance has become a global problem, the intervention of an antimicrobial stewardship team (AST) is warranted. In hematological disorders, infectious complications are crucial owing to abnormal neutrophil function and decreased cell-mediated immunity. Despite the widespread implementation of AST intervention, the effectiveness of stewardship practices for immunocompromised patients remains uncertain. We determined the effect of AST interventions on carbapenem therapy in the department of hematology. Patients admitted to the department and undergoing carbapenem therapy were enrolled. We compared carbapenem use between the pre-AST (April 2016–March 2018) and post-AST (April 2018–March 2021) periods. Factors associated with long-term carbapenem therapy were investigated. Overall, 515 episodes of carbapenem therapy in 264 patients in the department were evaluated. According to the interrupted time series analysis, the number of days of therapy decreased with AST intervention (β = −0.263, p = 0.011). In multivariate analysis, predictive factors associated with long-term carbapenem therapy (>8 days) were outpatient onset, chronic obstructive pulmonary disease, acute myeloid leukemia, multiple myeloma, and infection with resistant bacteria (such as extended spectrum β-lactamases and AmpC) (95% confidence interval, 1.030–2.818, 1.067–66.667, 1.057–2.782, 0.168–0.742, and 1.382–5.750, respectively). The AST intervention reduced carbapenem use in patients with hematological disorders. MDPI 2023-02-02 /pmc/articles/PMC9951935/ /pubmed/36830213 http://dx.doi.org/10.3390/antibiotics12020302 Text en © 2023 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
Suzuki, Ayako
Yamaguchi, Fumihiro
Maeda, Masayuki
Hashiguchi, Miyuki
Kabasawa, Nobuyuki
Sasaki, Jun
Sato, Tokutada
Fuyama, Masaki
Yamazaki, Yohei
Endo, Kei
Iwata, Kae
Kobayashi, Sei
Fujihara, Hisato
Antimicrobial Stewardship Program for Patients in the Hematological Department Receiving Carbapenem Therapy: A Single-Center and Interrupted Time Series Analysis
title Antimicrobial Stewardship Program for Patients in the Hematological Department Receiving Carbapenem Therapy: A Single-Center and Interrupted Time Series Analysis
title_full Antimicrobial Stewardship Program for Patients in the Hematological Department Receiving Carbapenem Therapy: A Single-Center and Interrupted Time Series Analysis
title_fullStr Antimicrobial Stewardship Program for Patients in the Hematological Department Receiving Carbapenem Therapy: A Single-Center and Interrupted Time Series Analysis
title_full_unstemmed Antimicrobial Stewardship Program for Patients in the Hematological Department Receiving Carbapenem Therapy: A Single-Center and Interrupted Time Series Analysis
title_short Antimicrobial Stewardship Program for Patients in the Hematological Department Receiving Carbapenem Therapy: A Single-Center and Interrupted Time Series Analysis
title_sort antimicrobial stewardship program for patients in the hematological department receiving carbapenem therapy: a single-center and interrupted time series analysis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9951935/
https://www.ncbi.nlm.nih.gov/pubmed/36830213
http://dx.doi.org/10.3390/antibiotics12020302
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