Long-term impact of competitive biddings and an antimicrobial stewardship program in a general hospital in Chile

ABSTRACT Background: The long-term effect of an antimicrobial stewardship program (ASP) and its integrated impact with competitive biddings have been seldom reported. Aim: To evaluate the long-term effect of an ASP on antimicrobial consumption, expenditure, antimicrobial resistance and hospital mo...

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Autores principales:	Fica,Alberto, Valenzuela,Claudia, Leiva,Ignacio, Vergara,Teresa, Soto,Andrés, Dabanch,Jeannette, Magunacelaya,Patricia
Lenguaje:	English
Publicado:	Sociedad Médica de Santiago 2018
Materias:	Antimicrobial Stewardship Competitive Bidding Drug Resistance, Bacterial
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872018000900968
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spelling	oai:scielo:S0034-988720180009009682019-02-13Long-term impact of competitive biddings and an antimicrobial stewardship program in a general hospital in ChileFica,AlbertoValenzuela,ClaudiaLeiva,IgnacioVergara,TeresaSoto,AndrésDabanch,JeannetteMagunacelaya,Patricia Antimicrobial Stewardship Competitive Bidding Drug Resistance, Bacterial ABSTRACT Background: The long-term effect of an antimicrobial stewardship program (ASP) and its integrated impact with competitive biddings have been seldom reported. Aim: To evaluate the long-term effect of an ASP on antimicrobial consumption, expenditure, antimicrobial resistance and hospital mortality. To estimate the contribution of competitive biddings on cost-savings. Material and Methods: A comparison of periods prior (2005-2008) and posterior to ASP initiation (2009 and 2015) was done. An estimation of cost savings attributable to ASP and to competitive biddings was also performed. Results: Basal median antimicrobial consumption decreased from 221.3 to 170 daily defined doses/100 beds after the start of the ASP. At the last year, global antimicrobial consumption declined by 28%. Median antimicrobial expenditure per bed (initially US$ 13) declined to US$ 10 at the first year (-28%) and to US$ 6 the last year (-57%). As the reduction in consumption was lower than the reduction in expenditure during the last year, we assumed that only 48.4% of savings were attributable to the ASP. According to antimicrobial charges per bed from prior and after ASP implementation, we estimated global savings of US$ 393072 and US$ 190000 directly attributable to the ASP, difference explained by parallel competitive biddings. Drug resistance among nosocomial bacterial isolates did not show significant changes. Global and infectious disease-associated mortality per 1000 discharges significantly decreased during the study period (p < 0.05). Conclusions: The ASP had a favorable impact on antimicrobial consumption, savings and mortality rates but did not have effect on antimicrobial resistance in selected bacterial strains.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.146 n.9 20182018-09-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872018000900968en10.4067/s0034-98872018000900968
institution	Scielo Chile
collection	Scielo Chile
language	English
topic	Antimicrobial Stewardship Competitive Bidding Drug Resistance, Bacterial
spellingShingle	Antimicrobial Stewardship Competitive Bidding Drug Resistance, Bacterial Fica,Alberto Valenzuela,Claudia Leiva,Ignacio Vergara,Teresa Soto,Andrés Dabanch,Jeannette Magunacelaya,Patricia Long-term impact of competitive biddings and an antimicrobial stewardship program in a general hospital in Chile
description	ABSTRACT Background: The long-term effect of an antimicrobial stewardship program (ASP) and its integrated impact with competitive biddings have been seldom reported. Aim: To evaluate the long-term effect of an ASP on antimicrobial consumption, expenditure, antimicrobial resistance and hospital mortality. To estimate the contribution of competitive biddings on cost-savings. Material and Methods: A comparison of periods prior (2005-2008) and posterior to ASP initiation (2009 and 2015) was done. An estimation of cost savings attributable to ASP and to competitive biddings was also performed. Results: Basal median antimicrobial consumption decreased from 221.3 to 170 daily defined doses/100 beds after the start of the ASP. At the last year, global antimicrobial consumption declined by 28%. Median antimicrobial expenditure per bed (initially US$ 13) declined to US$ 10 at the first year (-28%) and to US$ 6 the last year (-57%). As the reduction in consumption was lower than the reduction in expenditure during the last year, we assumed that only 48.4% of savings were attributable to the ASP. According to antimicrobial charges per bed from prior and after ASP implementation, we estimated global savings of US$ 393072 and US$ 190000 directly attributable to the ASP, difference explained by parallel competitive biddings. Drug resistance among nosocomial bacterial isolates did not show significant changes. Global and infectious disease-associated mortality per 1000 discharges significantly decreased during the study period (p < 0.05). Conclusions: The ASP had a favorable impact on antimicrobial consumption, savings and mortality rates but did not have effect on antimicrobial resistance in selected bacterial strains.
author	Fica,Alberto Valenzuela,Claudia Leiva,Ignacio Vergara,Teresa Soto,Andrés Dabanch,Jeannette Magunacelaya,Patricia
author_facet	Fica,Alberto Valenzuela,Claudia Leiva,Ignacio Vergara,Teresa Soto,Andrés Dabanch,Jeannette Magunacelaya,Patricia
author_sort	Fica,Alberto
title	Long-term impact of competitive biddings and an antimicrobial stewardship program in a general hospital in Chile
title_short	Long-term impact of competitive biddings and an antimicrobial stewardship program in a general hospital in Chile
title_full	Long-term impact of competitive biddings and an antimicrobial stewardship program in a general hospital in Chile
title_fullStr	Long-term impact of competitive biddings and an antimicrobial stewardship program in a general hospital in Chile
title_full_unstemmed	Long-term impact of competitive biddings and an antimicrobial stewardship program in a general hospital in Chile
title_sort	long-term impact of competitive biddings and an antimicrobial stewardship program in a general hospital in chile
publisher	Sociedad Médica de Santiago
publishDate	2018
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872018000900968
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Long-term impact of competitive biddings and an antimicrobial stewardship program in a general hospital in Chile

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