Long-term outcomes of an educational paediatric antimicrobial stewardship programme : a quality improvement study
© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ..
BACKGROUND AND OBJECTIVES: Antimicrobial stewardship programmes (ASPs) have resulted in antimicrobial consumption (AMC) reduction and quality of prescription (QOP) improvement. However, evidence of ASP impact in paediatrics is still limited. This study aims to assess a paediatric ASP long-term outcomes.
METHODS: A quality improvement study assessed by a interrupted time series analysis was conducted in a paediatric tertiary hospital. QOP expressed as proportion of adequate prescriptions, AMC measured by defined daily dose incidence per 1000 occupied bed days, incidence density of bloodstream infections (BSIs) and its related all-cause crude death rate (CDR) were compared between pre (from January 2013 to December 2015) and post (from January 2016 to December 2019) ASP activities intensification, which included a dedicated paediatric infectious diseases physician to actively perform educational interviews with prescribers.
RESULTS: Inappropriate prescribing showed a significant downward shift associated to the intervention with a -51.4% (-61.2% to -41.8%) reduction with respect to the expected values. Overall AMC showed no trend change after the intervention. For neonatology a28.8% (-36.8% to -20.9%) reduction was observed. Overall anti-pseudomonal cephalosporin use showed a -51.2% (-57.0% to -45.4%) reduction. Decreasing trends were observed for carbapenem use, with a quarterly per cent change (QPC) of -2.4% (-4.3% to -0.4%) and BSI-related CDR (QPC=-3.6%; -5.4% to -1.7%) through the study period. Healthcare-associated multi-drug-resistant BSI remained stable (QPC=2.1; -0.6 to 4.9).
CONCLUSIONS: Intensification of counselling educational activities within an ASP suggests to improve QOP and to partially reduce AMC in paediatric patients. The decreasing trends in mortality remained unchanged.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:109 |
|---|---|
| Enthalten in: |
Archives of disease in childhood - 109(2024), 2 vom: 22. Jan., Seite 144-151 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Aboza Garcia, Marta [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Anti-Bacterial Agents |
|---|
| Anmerkungen: |
Date Completed 24.01.2024 Date Revised 23.02.2024 published: Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1136/archdischild-2022-323802 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM364321008 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM364321008 | ||
| 003 | DE-627 | ||
| 005 | 20240229143822.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1136/archdischild-2022-323802 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1303.xml |
| 035 | |a (DE-627)NLM364321008 | ||
| 035 | |a (NLM)37940361 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Aboza Garcia, Marta |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Long-term outcomes of an educational paediatric antimicrobial stewardship programme |b a quality improvement study |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 24.01.2024 | ||
| 500 | |a Date Revised 23.02.2024 | ||
| 500 | |a published: Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ. | ||
| 520 | |a BACKGROUND AND OBJECTIVES: Antimicrobial stewardship programmes (ASPs) have resulted in antimicrobial consumption (AMC) reduction and quality of prescription (QOP) improvement. However, evidence of ASP impact in paediatrics is still limited. This study aims to assess a paediatric ASP long-term outcomes | ||
| 520 | |a METHODS: A quality improvement study assessed by a interrupted time series analysis was conducted in a paediatric tertiary hospital. QOP expressed as proportion of adequate prescriptions, AMC measured by defined daily dose incidence per 1000 occupied bed days, incidence density of bloodstream infections (BSIs) and its related all-cause crude death rate (CDR) were compared between pre (from January 2013 to December 2015) and post (from January 2016 to December 2019) ASP activities intensification, which included a dedicated paediatric infectious diseases physician to actively perform educational interviews with prescribers | ||
| 520 | |a RESULTS: Inappropriate prescribing showed a significant downward shift associated to the intervention with a -51.4% (-61.2% to -41.8%) reduction with respect to the expected values. Overall AMC showed no trend change after the intervention. For neonatology a28.8% (-36.8% to -20.9%) reduction was observed. Overall anti-pseudomonal cephalosporin use showed a -51.2% (-57.0% to -45.4%) reduction. Decreasing trends were observed for carbapenem use, with a quarterly per cent change (QPC) of -2.4% (-4.3% to -0.4%) and BSI-related CDR (QPC=-3.6%; -5.4% to -1.7%) through the study period. Healthcare-associated multi-drug-resistant BSI remained stable (QPC=2.1; -0.6 to 4.9) | ||
| 520 | |a CONCLUSIONS: Intensification of counselling educational activities within an ASP suggests to improve QOP and to partially reduce AMC in paediatric patients. The decreasing trends in mortality remained unchanged | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Infectious Disease Medicine | |
| 650 | 4 | |a Microbiology | |
| 650 | 4 | |a Paediatrics | |
| 650 | 7 | |a Anti-Bacterial Agents |2 NLM | |
| 650 | 7 | |a Anti-Infective Agents |2 NLM | |
| 650 | 7 | |a Carbapenems |2 NLM | |
| 700 | 1 | |a Goycochea-Valdivia, Walter |e verfasserin |4 aut | |
| 700 | 1 | |a Peñalva, Germán |e verfasserin |4 aut | |
| 700 | 1 | |a Falcon Neyra, Lola |e verfasserin |4 aut | |
| 700 | 1 | |a Moleón Ruiz, Marta |e verfasserin |4 aut | |
| 700 | 1 | |a Rodriguez-Villodres, Angel |e verfasserin |4 aut | |
| 700 | 1 | |a Montero Valladares, Cristina |e verfasserin |4 aut | |
| 700 | 1 | |a Olbrich, Peter |e verfasserin |4 aut | |
| 700 | 1 | |a Sánchez-Valderrabanos, Elia |e verfasserin |4 aut | |
| 700 | 1 | |a Jiménez, Francisco |e verfasserin |4 aut | |
| 700 | 1 | |a Molina, Maria |e verfasserin |4 aut | |
| 700 | 1 | |a Moreno Madueño, Gloria |e verfasserin |4 aut | |
| 700 | 1 | |a Valencia Martin, Raquel |e verfasserin |4 aut | |
| 700 | 1 | |a Gil Navarro, Maria Victoria |e verfasserin |4 aut | |
| 700 | 1 | |a Molina, Jose |e verfasserin |4 aut | |
| 700 | 1 | |a Neth, Olaf |e verfasserin |4 aut | |
| 700 | 1 | |a Cisneros, Jose Miguel |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Archives of disease in childhood |d 1926 |g 109(2024), 2 vom: 22. Jan., Seite 144-151 |w (DE-627)NLM000013196 |x 1468-2044 |7 nnns |
| 773 | 1 | 8 | |g volume:109 |g year:2024 |g number:2 |g day:22 |g month:01 |g pages:144-151 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1136/archdischild-2022-323802 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 109 |j 2024 |e 2 |b 22 |c 01 |h 144-151 | ||