The Impact of the SARS-Cov2 Pandemic on a Persuasive Educational Antimicrobial Stewardship Program in a University Hospital in Southern Italy: A Pre-Post Study
Objectives: We evaluated the effect of the pandemic on the disruption of a persuasive educational antimicrobial stewardship program (ASP) conducted in a university hospital in southern Italy. Methods: In March 2020, the ASP, which began in January 2017 and was carried out at different times in 10 wa...
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2021
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oai:doaj.org-article:cb0a147f38c241f09f749b572178ec0c2021-11-25T16:24:52ZThe Impact of the SARS-Cov2 Pandemic on a Persuasive Educational Antimicrobial Stewardship Program in a University Hospital in Southern Italy: A Pre-Post Study10.3390/antibiotics101114052079-6382https://doaj.org/article/cb0a147f38c241f09f749b572178ec0c2021-11-01T00:00:00Zhttps://www.mdpi.com/2079-6382/10/11/1405https://doaj.org/toc/2079-6382Objectives: We evaluated the effect of the pandemic on the disruption of a persuasive educational antimicrobial stewardship program (ASP) conducted in a university hospital in southern Italy. Methods: In March 2020, the ASP, which began in January 2017 and was carried out at different times in 10 wards, was stopped due to the COVID-19 pandemic. We conducted an observational study with interrupted time series analysis to compare the antibiotic consumption and costs, average length of hospital stay and in-hospital mortality between 12 months before and 9 months after the interruption. Results: Four medical, four surgical wards and two ICUs were included in the study, for a total of 35,921 patient days. Among the medical wards we observed after the interruption a significant increase in fluoroquinolone use, with a change in trend (CT) of 0.996, <i>p</i> = 0.027. In the surgical wards, we observed a significant increase in the overall consumption, with a change in level (CL) of 24.4, <i>p</i> = 0.005, and in the use of third and fourth generation cephalosporins (CL 4.7, <i>p</i> = 0.003). In two ICUs, we observed a significant increase in piperacillin/tazobactam and fluoroquinolone consumption (CT 9.28, <i>p</i> = 0.019, and 2.4, <i>p</i> = 0.047). In the wards with a duration of ASP less than 30 months, we observed a significant increase in antibiotic consumption in the use of piperacillin/tazobactam and fluoroquinolones (CT 12.9, <i>p</i> = 0.022: 4.12, <i>p</i> = 0.029; 1.004, <i>p</i> = 0.011). Conclusions: The interruption of ASP during COVID-19 led to an increase in the consumption of broad-spectrum antibiotics, particularly in surgical wards and in those with a duration of ASP less than 30 months.Margherita MaceraLorenzo OnoratoFederica CalòCaterina MonariRosa AnnibaleGiuseppe SignorielloGiovanna DonnarummaMaria Vittoria MontemurroMassimiliano GaldieroNicola CoppolaMDPI AGarticleSARS-CoV-2antimicrobial stewardship programDDDantimicrobial resistanceCOVID-19Therapeutics. PharmacologyRM1-950ENAntibiotics, Vol 10, Iss 1405, p 1405 (2021) |
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EN |
| topic |
SARS-CoV-2 antimicrobial stewardship program DDD antimicrobial resistance COVID-19 Therapeutics. Pharmacology RM1-950 |
| spellingShingle |
SARS-CoV-2 antimicrobial stewardship program DDD antimicrobial resistance COVID-19 Therapeutics. Pharmacology RM1-950 Margherita Macera Lorenzo Onorato Federica Calò Caterina Monari Rosa Annibale Giuseppe Signoriello Giovanna Donnarumma Maria Vittoria Montemurro Massimiliano Galdiero Nicola Coppola The Impact of the SARS-Cov2 Pandemic on a Persuasive Educational Antimicrobial Stewardship Program in a University Hospital in Southern Italy: A Pre-Post Study |
| description |
Objectives: We evaluated the effect of the pandemic on the disruption of a persuasive educational antimicrobial stewardship program (ASP) conducted in a university hospital in southern Italy. Methods: In March 2020, the ASP, which began in January 2017 and was carried out at different times in 10 wards, was stopped due to the COVID-19 pandemic. We conducted an observational study with interrupted time series analysis to compare the antibiotic consumption and costs, average length of hospital stay and in-hospital mortality between 12 months before and 9 months after the interruption. Results: Four medical, four surgical wards and two ICUs were included in the study, for a total of 35,921 patient days. Among the medical wards we observed after the interruption a significant increase in fluoroquinolone use, with a change in trend (CT) of 0.996, <i>p</i> = 0.027. In the surgical wards, we observed a significant increase in the overall consumption, with a change in level (CL) of 24.4, <i>p</i> = 0.005, and in the use of third and fourth generation cephalosporins (CL 4.7, <i>p</i> = 0.003). In two ICUs, we observed a significant increase in piperacillin/tazobactam and fluoroquinolone consumption (CT 9.28, <i>p</i> = 0.019, and 2.4, <i>p</i> = 0.047). In the wards with a duration of ASP less than 30 months, we observed a significant increase in antibiotic consumption in the use of piperacillin/tazobactam and fluoroquinolones (CT 12.9, <i>p</i> = 0.022: 4.12, <i>p</i> = 0.029; 1.004, <i>p</i> = 0.011). Conclusions: The interruption of ASP during COVID-19 led to an increase in the consumption of broad-spectrum antibiotics, particularly in surgical wards and in those with a duration of ASP less than 30 months. |
| format |
article |
| author |
Margherita Macera Lorenzo Onorato Federica Calò Caterina Monari Rosa Annibale Giuseppe Signoriello Giovanna Donnarumma Maria Vittoria Montemurro Massimiliano Galdiero Nicola Coppola |
| author_facet |
Margherita Macera Lorenzo Onorato Federica Calò Caterina Monari Rosa Annibale Giuseppe Signoriello Giovanna Donnarumma Maria Vittoria Montemurro Massimiliano Galdiero Nicola Coppola |
| author_sort |
Margherita Macera |
| title |
The Impact of the SARS-Cov2 Pandemic on a Persuasive Educational Antimicrobial Stewardship Program in a University Hospital in Southern Italy: A Pre-Post Study |
| title_short |
The Impact of the SARS-Cov2 Pandemic on a Persuasive Educational Antimicrobial Stewardship Program in a University Hospital in Southern Italy: A Pre-Post Study |
| title_full |
The Impact of the SARS-Cov2 Pandemic on a Persuasive Educational Antimicrobial Stewardship Program in a University Hospital in Southern Italy: A Pre-Post Study |
| title_fullStr |
The Impact of the SARS-Cov2 Pandemic on a Persuasive Educational Antimicrobial Stewardship Program in a University Hospital in Southern Italy: A Pre-Post Study |
| title_full_unstemmed |
The Impact of the SARS-Cov2 Pandemic on a Persuasive Educational Antimicrobial Stewardship Program in a University Hospital in Southern Italy: A Pre-Post Study |
| title_sort |
impact of the sars-cov2 pandemic on a persuasive educational antimicrobial stewardship program in a university hospital in southern italy: a pre-post study |
| publisher |
MDPI AG |
| publishDate |
2021 |
| url |
https://doaj.org/article/cb0a147f38c241f09f749b572178ec0c |
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