Effects of a comprehensive antimicrobial stewardship program in a surgical intensive care unit
- Authors
- Kim, S.-H.[Kim, S.-H.]; Yoon, J.G.[Yoon, J.G.]; Park, H.J.[Park, H.J.]; Won, H.[Won, H.]; Ryoo, S.S.[Ryoo, S.S.]; Choi, E.[Choi, E.]; Park, E.-K.[Park, E.-K.]; Huh, K.[Huh, K.]; Park, C.-M.[Park, C.-M.]
- Issue Date
- Jul-2021
- Publisher
- Elsevier B.V.
- Keywords
- Antimicrobial stewardship; Critical care; Drug resistance; Microbial; Mortality
- Citation
- International Journal of Infectious Diseases, v.108, pp.237 - 243
- Indexed
- SCIE
SCOPUS
- Journal Title
- International Journal of Infectious Diseases
- Volume
- 108
- Start Page
- 237
- End Page
- 243
- URI
- https://scholarworks.bwise.kr/skku/handle/2021.sw.skku/91938
- DOI
- 10.1016/j.ijid.2021.02.082
- ISSN
- 1201-9712
- Abstract
- Objectives: We evaluated the effects of a comprehensive antimicrobial stewardship program (ASP) in a surgical intensive care unit (SICU). Methods: The ASP was implemented from March 2018 to February 2019 at an SICU in a teaching hospital. An infectious disease physician and a pharmacist visited the SICU 3 times per week for prospective audit and feedback. Outcomes were compared between the ASP period and the same months in the preceding year (pre-ASP period). The primary outcome measure was the use of anti-pseudomonal beta-lactams (APBL). Appropriate antimicrobial de-escalation and ICU mortality rates were also compared. Results: A total of 182 and 149 patients were included in the study for the pre-ASP and ASP periods, respectively. Although disease severity was higher in the ASP group (septic shock 39.0% in pre-ASP vs 65.1% in ASP group, P < 0.001), the use of APBL as a definitive treatment was lower during ASP (68.7% vs 57.7%, OR 0.62, 95% CI 0.40–0.98). Appropriate antimicrobial de-escalation improved (63.2% vs 94.6%, P < 0.001). ICU mortality was comparable (7.7% vs 7.4%) and significantly lower during the ASP, after adjustment (adjusted OR 0.41, 95% CI 0.18–0.92, P = 0.032). Conclusions: A comprehensive ASP decreased the use of APBL and was associated with improved patient outcomes. © 2021
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Collections - Medicine > Department of Medicine > 1. Journal Articles
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