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The effect of intervention by an antimicrobial stewardship team on anaerobic bacteremia.
Anaerobe ( IF 2.3 ) Pub Date : 2020-05-21 , DOI: 10.1016/j.anaerobe.2020.102214
Gaku Kuwabara 1 , Satomi Yukawa 1 , Koichi Yamada 2 , Waki Imoto 1 , Kazushi Yamairi 3 , Wataru Shibata 3 , Naoko Yoshii 3 , Tetsuya Watanabe 4 , Kazuhisa Asai 4 , Makoto Niki 5 , Kiyotaka Nakaie 5 , Yasuyo Okada 5 , Akiko Fujita 5 , Yukihiro Kaneko 6 , Tomoya Kawaguchi 4 , Hiroshi Kakeya 2
Affiliation  

The effect of antimicrobial stewardship (AS) on anaerobic bacteremia is uncertain. This study aimed to assess the effect of interventions by the AS team (AST) on clinical and microbiological outcomes and antimicrobial use. An AS program was introduced at Osaka City University Hospital in January 2014; an interdisciplinary AST was established. We enrolled patients with anaerobic bacteremia between January 2009 and December 2018. Patients were classified into the pre-intervention group (from January 2009 to December 2013) and the post-intervention group (from January 2014 to December 2018). A significant decrease in definitive carbapenem use (P = 0.0242) and an increase in empiric tazobactam/piperacillin use (P = 0.0262) were observed in the post-intervention group. The de-escalation rate increased significantly from 9.38% to 32.7% (P = 0.0316) in the post-intervention group. The susceptibility of Bacteroides species and 30-day mortality did not worsen in the post-intervention group. These results showed that interventions by an AST can reduce carbapenem use and increase the de-escalation rate without worsening patient outcomes.



中文翻译:

抗菌管理小组干预对厌氧菌血症的影响。

抗菌素(AS)对厌氧菌血症的影响尚不确定。这项研究旨在评估AS小组(AST)干预对临床和微生物结局以及抗菌药物使用的影响。2014年1月在大阪市立大学医院引进了AS计划;建立了跨学科的AST。我们招募了2009年1月至2018年12月之间的厌氧菌血症患者。患者分为干预前组(从2009年1月至2013年12月)和干预后组(从2014年1月至2018年12月)。在干预后组中,确定的碳青霉烯的使用量显着减少(P = 0.0242),经验性他唑巴坦/哌拉西林的使用量增加(P = 0.0262)。降级率从9.38%显着增加到32.7%(P = 0。0316)在干预后组中。的易感性干预后组中的拟杆菌种类和30天死亡率没有恶化。这些结果表明,AST的干预措施可以减少碳青霉烯的使用并增加降级率,而不会恶化患者的预后。

更新日期:2020-05-21
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