Reducing the duration of antibiotic therapy in surgical patients through a specific nationwide antimicrobial stewardship program. A prospective, interventional cohort study

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• dc.contributor.author Batlle, Maria
• dc.contributor.author Badia, Josep M.
• dc.contributor.author Hernández, Sergi
• dc.contributor.author Grau Cerrato, Santiago
• dc.contributor.author Padulles, Ariadna
• dc.contributor.author Boix Palop, Lucía
• dc.contributor.author Giménez-Pérez, Montserrat
• dc.contributor.author Ferrer, Ricard
• dc.contributor.author Calbo, Esther
• dc.contributor.author Limón, Enric
• dc.contributor.author Pujol, Miquel
• dc.contributor.author Horcajada Gallego, Juan Pablo
• dc.contributor.author 7VINCut Study Group; VINCat Program
• dc.date.accessioned 2024-05-17T05:45:27Z
• dc.date.available 2024-05-17T05:45:27Z
• dc.date.issued 2023
• dc.description.abstract Background: Guidelines recommend 5-7 days of antibiotic treatment in patients with surgical infection and adequate source control. This nationwide stewardship intervention aimed to reduce the duration of treatments in surgical patients to <7 days. Methods: Prospective cohort study evaluating surgical patients receiving antibiotics ≥7 days in 32 hospitals. Indication for treatment, quality of source control, type of recommendations issued, and adherence to the recommendations were analysed. Temporal trends in the percentages of patients with treatment >7 days were evaluated using a linear regression model and Pearson's correlation coefficients. Results: A total of 32 499 patients were included. Of these, 13.7% had treatments ≥7 days. In all, 3912 stewardship interventions were performed, primarily in general surgery (90.7%) and urology (8.1%). The main types of infection were intra-abdominal (73.4%), skin/soft tissues (9.8%) and urinary (9.2%). The septic focus was considered controlled in 59.9% of cases. Out of 5458 antibiotic prescriptions, the most frequently analysed drugs were piperacillin/tazobactam (21.7%), metronidazole (11.2%), amoxicillin/clavulanate (10.3%), meropenem (10.7%), ceftriaxone (9.3%) and ciprofloxacin (6.7%). The main recommendations issued were: treatment discontinuation (35.0%), maintenance (40.0%) or de-escalation (15.5%), and the overall adherence rate was 91.5%. With adequate source control, the most frequent recommendation was to terminate treatment (51.2%). Throughout the study period, a significant decrease in the percentage of prolonged treatments was observed (Pc=-0.69;P < 0.001). Conclusions: This stewardship programme reduced the duration of treatments in surgical departments. Preference was given to general surgery services, intra-abdominal infection, and beta-lactam antibiotics, including carbapenems. Adherence to the issued recommendations was high.
• dc.format.mimetype application/pdf
• dc.identifier.citation Batlle M, Badia JM, Hernández S, Grau S, Padulles A, Boix-Palop L, et al. Reducing the duration of antibiotic therapy in surgical patients through a specific nationwide antimicrobial stewardship program. A prospective, interventional cohort study. Int J Antimicrob Agents. 2023 Nov;62(5):106943. DOI: 10.1016/j.ijantimicag.2023.106943
• dc.identifier.doi http://dx.doi.org/10.1016/j.ijantimicag.2023.106943
• dc.identifier.issn 0924-8579
• dc.identifier.uri http://hdl.handle.net/10230/60176
• dc.language.iso eng
• dc.publisher Elsevier
• dc.relation.ispartof Int J Antimicrob Agents. 2023 Nov;62(5):106943
• dc.rights © 2023 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/4.0/
• dc.subject.keyword Anti-Bacterial Agents / therapeutic use
• dc.subject.keyword Antimicrobial Stewardship / organization and administration
• dc.subject.keyword Drug Resistance, Multiple, Bacterial / drug effects
• dc.subject.keyword General Surgery / standards
• dc.subject.keyword Infection Control / organization and administration
• dc.subject.keyword Surgical Wound Infection / prevention and control
• dc.title Reducing the duration of antibiotic therapy in surgical patients through a specific nationwide antimicrobial stewardship program. A prospective, interventional cohort study
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion