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Infection

pp 1–8 | Cite as

Sustainable implementation of antibiotic stewardship on a surgical intensive care unit evaluated over a 10-year period

  • Stefan SchröderEmail author
  • Marie-Kathrin Klein
  • Bernhard Heising
  • Sebastian W. Lemmen
Original Paper

Abstract

Objective

This retrospective observational study examined the implementation of antibiotic stewardship (ABS) on the surgical intensive care unit (SICU) of a specialized academic teaching hospital.

Methods

Application density of antimicrobial agents (ADA), substance class change, development of resistance, and clinical outcomes were investigated with reference to ABS in three intervals over a 10-year period: the pre-intervention phase (2008–2010), the intervention phase (2011–2014), and the post-intervention phase (2015–2017).

Results

Following the introduction of ABS, ADA was reduced from 89.3 recommended daily doses/100 patient days (RDD/100 PD) at the pre-intervention phase to 68.0 RDD/100 PD at the post-intervention phase. The antibiotic ADA (AB-ADA) similarly showed a significant decrease from 83.3 to 62.0 RDD/100 PD (p < 0.0001). The case mix index (CMI), which describes the average case severity across patients and mortality on the SICU was not significantly different comparing intervention and post-intervention phase. It was also possible to achieve a substance class change following the introduction of ABS. There was no obvious change in bacterial resistance rates.

Conclusion

The study demonstrates a sustainable effect of the implementation of ABS, which was sustained through the post-intervention phase.

Keywords

Antibiotic stewardship Antimicrobial agents Intensive care medicine Outcome Sustainability 

Notes

Acknowledgement

The authors would like to thank Thomas Ploch of COMESTA (Consulting Methods and Statistics) of Marburg, Germany, for his excellent advice and support in applying the statistical analysis.

Compliance with ethical standards

Conflicts of interest

The authors indicate that no conflicts of interest exist.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Anesthesiology and Intensive Care MedicineDüren HospitalDürenGermany
  2. 2.Department of Infection Control and Infectious DiseasesDüren Hospital52351 DürenGermany
  3. 3.Department of Infection Control and Infectious DiseasesRWTH University Hospital Aachen52074 AachenGermany

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