Abstract:
OBJECTIVE To evaluate the impact of antimicrobial stewardship (AMS) on antimicrobial use indicators in hospitalized patients and to provide references for the rational use and management of antimicrobials.
METHODS Data on antimicrobial-related indicators for hospitalized patients were retrieved from Hainan Hospital of the Chinese PLA General Hospital for the periods from Jan. 2023 to Dec. 2023 (pre-AMS) and from Jan. 2024 to Dec. 2024 (post-AMS). This included 11 key indicators: antimicrobial use rate, antimicrobial use density (AUD), microbial submission rate, hospital-acquired infection rate, multidrug-resistant organism (MDRO) detection rate and others. Changes in these antimicrobial use indicators among hospitalized patients before and after AMS implementation were analyzed to evaluate the effectiveness of AMS.
RESULTS Compared with the pre-AMS period, all antimicrobial indicators showed favorable improvements in the post-AMS period. The proportion of antimicrobial costs among inpatients (18.80% vs. 13.71%), average antimicrobial costs per inpatient admission (RMB 1 600.83±291.40 vs. RMB 1 035.94±243.34), use rate of antimicrobials among inpatients (39.23% vs. 34.91%), prophylactic use rate of antimicrobials for type Ⅰ incisions (30.14% vs. 23.26%), combination therapy rate of antimicrobials (27.20% vs. 21.10%), AUD (52.99±5.17 DDDs vs. 41.46±6.31 DDDs), incidence of hospital-associated infections (1.26% vs. 0.71%), detection rate of carbapenem-resistant Enterobacteriaceae (CRE) (4.64% vs. 2.31%) and detection rate of methicillin-resistant Staphylococcus aureus (MRSA) (23.58% vs. 14.45%) all significantly decreased (P < 0.05). The appropriateness rate of antimicrobial prophylaxis for type Ⅰ incisions (64.20% vs. 67.85%), microbial submission rate before antimicrobial use (35.31% vs. 42.28%) and microbial submission rate before the use of restricted-level antimicrobials (48.62% vs. 55.28%) all significantly increased (P < 0.05).
CONCLUSION Through the implementation of AMS at this hospital, antimicrobial use indicators in hospitalized patients are significantly improved, promoting the rational use of antimicrobials, reducing antimicrobial costs and effectively controlling the occurrence of hospital-associated infections and the spread of resistant bacteria.