Defining the scope of antimicrobial stewardship interventions on the prescription quality of antibiotics for surgical intra-abdominal infections

Please always quote using this URN: urn:nbn:de:bvb:20-opus-223034
  • Background: The aim of this study was to assess the impact of antimicrobial stewardship interventions on surgical antibiotic prescription behavior in the management of non-elective surgical intra-abdominal infections, focusing on postoperative antibiotic use, including the appropriateness of indications. Methods: A single-center quality improvement study with retrospective evaluation of the impact of antimicrobial stewardship measures on optimizing antibacterial use in intra-abdominal infections requiring emergency surgery was performed. TheBackground: The aim of this study was to assess the impact of antimicrobial stewardship interventions on surgical antibiotic prescription behavior in the management of non-elective surgical intra-abdominal infections, focusing on postoperative antibiotic use, including the appropriateness of indications. Methods: A single-center quality improvement study with retrospective evaluation of the impact of antimicrobial stewardship measures on optimizing antibacterial use in intra-abdominal infections requiring emergency surgery was performed. The study was conducted in a tertiary hospital in Germany from January 1, 2016, to January 30, 2020, three years after putting a set of antimicrobial stewardship standards into effect. Results: 767 patients were analyzed (n = 495 in 2016 and 2017, the baseline period; n = 272 in 2018, the antimicrobial stewardship period). The total days of therapy per 100 patient days declined from 47.0 to 42.2 days (p = 0.035). The rate of patients receiving postoperative therapy decreased from 56.8% to 45.2% (p = 0.002), comparing both periods. There was a significant decline in the rate of inappropriate indications (17.4% to 8.1 %, p = 0.015) as well as a significant change from broad-spectrum to narrow-spectrum antibiotic use (28.8% to 6.5%, p ≤ 0.001) for postoperative therapy. The significant decline in antibiotic use did not affect either clinical outcomes or the rate of postoperative wound complications. Conclusions: Postoperative antibiotic use for intra-abdominal infections could be significantly reduced by antimicrobial stewardship interventions. The identification of inappropriate indications remains a key target for antimicrobial stewardship programs.show moreshow less

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Metadaten
Author: Güzin Surat, Ulrich Vogel, Armin Wiegering, Christoph-Thomas Germer, Johan Friso Lock
URN:urn:nbn:de:bvb:20-opus-223034
Document Type:Journal article
Faculties:Medizinische Fakultät / Klinik und Poliklinik für Allgemein-, Viszeral-, Gefäß- und Kinderchirurgie (Chirurgische Klinik I)
Medizinische Fakultät / Institut für Hygiene und Mikrobiologie
Language:English
Parent Title (English):Antibiotics
ISSN:2079-6382
Year of Completion:2021
Volume:10
Issue:1
Article Number:73
Source:Antibiotics (2021) 10:1, 73. https://doi.org/10.3390/antibiotics10010073
DOI:https://doi.org/10.3390/antibiotics10010073
Sonstige beteiligte Institutionen:Krankenhaushygiene und Antimicrobial Stewardship
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Tag:antibiotic prescription behavior; antimicrobial stewardship; post-operative antibiotic treatment; surgical intra-abdominal infections
Release Date:2022/06/21
Date of first Publication:2021/01/14
Licence (German):License LogoCC BY: Creative-Commons-Lizenz: Namensnennung 4.0 International