1412. Impact of a Comprehensive Antimicrobial Stewardship Program at a Tertiary Care Teaching Hospital in Argentina
Session: Poster Abstract Session: Antimicrobial Stewardship: Interventions
Saturday, October 10, 2015
Room: Poster Hall
Posters
  • IDSA2015_AMS_HUA_Poster.pdf (1.2 MB)
  • Background: The growing emergence of multidrug-resistant microorganisms, in addition to the lack of development of new antimicrobial molecules, requires the implementation of effective antimicrobial stewardship programs (ASPs) in order to optimize clinical outcomes, while minimizing unintended consequences of antimicrobial use, including toxicity, and the selection and the emergence of resistant pathogenic organisms. In this sense, the aim of this study was to determine the impact of a comprehensive ASP through a multidisciplinary team at a tertiary care teaching hospital

    Methods: Between April-2013 to March-2015, all patients admitted to the institution, receiving antimicrobial treatment at any time during the admission, were included into the study and were prospectively followed. A multidisciplinary antimicrobial stewardship team was convened to implement the following interventions: obtain the ASP approval from the hospital authorities, adapting international guidelines to the local situation, provide systematic education on antimicrobial use, perform prospective audit with intervention and feedback to prescriber. In order to evaluate the impact of the ASP, each quarter data were compared to the basal period (Apr-Jun 2013) through the following indicators: total antimicrobial use: total Defined Daily Doses (t-DDD) per 1000 patient-days; antimicrobial cost: USD per 1000 patient-days; antimicrobial inappropriate use: inappropriate DDD (i-DDD) per 1000 t-DDD, and quality indicators:mortality per 100 discharges; length of stay

    Results: During the study period, 1,547 i-DDD were found in 95,316 t-DDD (18.17 i-DDD per 1000 t-DDD; 95%CI 18.08–18.26). Higher rates were found in ICUs in comparison with General Wards and Bone Marrow Transplantation Unit (21.76; 17.26 and 11.53, respectively; p<0.001). Across the study, an absolute cumulative reduction was observed in the following indicators: antimicrobial use: 1027 t-DDD per 1000 p-d (95%CI 1013 to 1038; p<0.001); inappropriate use: 111.3 i-DDD per 1000 t-DDD (95%CI 106.7 to 119.9; p>0.001); antimicrobial costs:USD 531,096 per 1000 p-d (95%CI 530,700 to 531,757; p<0.001). No significant differences in the quality indicators were observed

    Conclusion: The implementation of a comprehensive ASP helped to optimize the antimicrobial use by reducing its misuse, without negative impact in quality indicators

    Rodolfo Quiros, MD1, Mariana Valerio, PH2, Maria Casanova, MD1, Maria Pereyra Acuņa, MD1, Guillermina Kremer, MD1 and Viviana Vilches, PH3, (1)Prevention and Control Infection Department, HOSPITAL UNIVERSITARIO AUSTRAL, PILAR, Argentina, (2)Pharmacy, HOSPITAL UNIVERSITARIO AUSTRAL, PILAR, Anguilla, (3)Laboratory of Microbiology, HOSPITAL UNIVERSITARIO AUSTRAL, PILAR, Argentina

    Disclosures:

    R. Quiros, None

    M. Valerio, None

    M. Casanova, None

    M. Pereyra Acuņa, None

    G. Kremer, None

    V. Vilches, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 7th with the exception of research findings presented at the IDWeek press conferences.