[Impact of an antimicrobial stewardship program in a pediatric third level hospital in Panama]

Rev Chilena Infectol. 2020 Feb;37(1):9-18. doi: 10.4067/S0716-10182020000100009.
[Article in Spanish]

Abstract

Background: Antimicrobial Stewardship Programs (ASP) focus in the appropriate use of antimicrobials to improve clinical results and minimize risk of adverse events.

Aims: To compare consumption and costs of antimicrobials before and after the establishment of an antimicrobial stewardship program and to describe the resistance proportion of priority bacteria.

Methods: Quasi-experimental, retrospective and prospective, descriptive and analytical study, to compare consumption and costs of antimicrobials in a pre- intervention period (2007-2010) and a post- intervention period (2011-2017). Additionally, a descriptive analysis of bacterial resistance from 2010 was performed.

Results: Gentamicin, vancomycin, meropenem, cefotaxime, ceftazidime and imipenem consumption decreased significantly in the post-intervention period compared to the pre-intervention period (p < 0.05) while consumption of amikacin, piperacillin/tazobactam, cefepime and levofloxacin increased significantly in the post-intervention period. The reduction in costs was not significant for gentamicin, vancomycin, meropenem, cefotaxime, ceftazidime and imipenem, meanwhile, costs increased for amikacin, piperacillin/tazobactam, cefepime and levofloxacin, but this was not significant. The isolation of Acinetobacter baumannii, Klebsiella pneumoniae, Staphylococcus aureus and Enterococcus faecalis decreased during the post-intervention period.

Conclusion: The ASP showed a decrease in consumption and costs of some antimicrobials.

MeSH terms

  • Anti-Bacterial Agents* / economics
  • Anti-Bacterial Agents* / therapeutic use
  • Antimicrobial Stewardship* / economics
  • Antimicrobial Stewardship* / standards
  • Antimicrobial Stewardship* / statistics & numerical data
  • Bacterial Infections* / drug therapy
  • Bacterial Infections* / prevention & control
  • Child
  • Hospitals, Pediatric / economics
  • Hospitals, Pediatric / statistics & numerical data
  • Humans
  • Microbial Sensitivity Tests
  • Panama
  • Preventive Health Services* / economics
  • Preventive Health Services* / standards
  • Preventive Health Services* / statistics & numerical data
  • Prospective Studies
  • Retrospective Studies

Substances

  • Anti-Bacterial Agents