Clinical Impact of an Antibiotic Stewardship Program at a Children’s Hospital
نویسندگان
چکیده
INTRODUCTION Antibiotic stewardship programs (ASP) improve appropriate antibiotic use. Data are limited on the clinical benefit of ASPs in children's hospitals. This study's objective was to determine the impact of an ASP on length of stay (LOS) and readmission rate among patients admitted to children's hospitals. METHODS Data from a prospective-audit-with-feedback ASP were used to examine the ASP review characteristics, including antibiotic(s) prescribed, clinical indication, recommendations made by the ASP, and agreement with recommendations. Propensity score analysis was utilized to determine the impact of the ASP on LOS and 30-day readmission based on whether the patient received an ASP recommendation and if the clinician agreed with recommendations. Patients were stratified on if they had a complex chronic condition status (CCC) and their service line, medical or surgical. RESULTS Of the 8038 reviews included, 1362 (16.9%) resulted in a recommendation that was agreed with in 1116 (81%) cases. Propensity score analysis demonstrated a significantly longer LOS for the non-CCC medicine group who received an ASP recommendation (80.9 vs. 67.6 h, p < 0.001). However, for CCC medicine patients that agreed with the ASP recommendation, a clinically relevant decrease in LOS (158.1 vs. 180.3 h, p = 0.095) was observed. The 30-day readmission rate was significantly greater in CCC medicine patients when comparing those who did not receive a recommendation versus those who did receive a recommendation (7.3% vs 4.2%, respectively; p = 0.005). CONCLUSION Children without a CCC who received an ASP recommendation had a longer length of stay. For children with CCCs, the ASP appeared to decrease LOS and significantly reduce 30-day readmission rates. Overall, this study demonstrate that ASPs offer meaningful clinical benefit justifying resource allocation needed to develop and maintain ASP programs.
منابع مشابه
Impact of Patient Diagnoses and Provider Years of Practice on Antimicrobial Stewardship Program (ASP) Activities at a Non-freestanding Children’s Hospital
متن کامل
Impact of Stewardship Intervention on Improving Antibiotic Prescribing Practices
Background: Antimicrobial stewardship programs (ASPs) have been found to be an effective method for minimizing antibiotic misuse. Method: A study comparing the quality of antibiotic prescriptions between a one-year period before ASP implementation and a one-year period after its implementation. For each period, antimicrobial prescriptions were evaluated by an antimicrobial stewardship team and ...
متن کامل220Ongoing Impact of an Antimicrobial Stewardship Program at A Large Academic Medical Center, 7 years of experience
220. Ongoing Impact of an Antimicrobial Stewardship Program at A Large Academic Medical Center, 7 years of experience Susan Kline, MD, MPH; Kimberly Boeser, PharmD, BCPS AQ-ID; Teresa Rakoczy, RN, BSN; Amanda Guspiel, MPH; Anita Guelcher, RN, BSN; Christine Hendrickson, RN, BSN; Pamela Phelps, PharmD; Medicine/Infectious Diseases, University of Minnesota Medical School and University of MN Medi...
متن کاملAntibiotic Prescribing Trends Before and After Implementation of an Audit and Feedback Program in Internal ward of a Tertiary Hospital in Tehran
We implemented a post prescribing review and feedback program to investigate its effect on appropriateness of antimicrobial use and antimicrobial consumption rate.A pre-post interventional study conducted in internal ward of Imam Hossein teaching hospital. For nine months of intervention phase, medical file of all patients who received intravenous antibiotic were reviewed by a clinical ph...
متن کاملAntibiotic Prescribing Trends Before and After Implementation of an Audit and Feedback Program in Internal ward of a Tertiary Hospital in Tehran
We implemented a post prescribing review and feedback program to investigate its effect on appropriateness of antimicrobial use and antimicrobial consumption rate.A pre-post interventional study conducted in internal ward of Imam Hossein teaching hospital. For nine months of intervention phase, medical file of all patients who received intravenous antibiotic were reviewed by a clinical ph...
متن کاملDoes An Antimicrobial Stewardship Program for Carbapenem Use Reduce Costs? An Observation in Tehran, Iran.
Introduction: Inappropriate administration of antimicrobials has led to increased antibiotic resistance as well as burden of infectious diseases. Antibiotic stewardship programs (ASPs) help prevent resistance through improved utilization of antimicrobial agents while potentially decrease costs of treatment. Method: We reviewed 186 infectious disease (ID) consultations from two internal disea...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
دوره 6 شماره
صفحات -
تاریخ انتشار 2017