Objectives

This study aimed to analyse the effect of discontinuation of antimicrobial stewardship programme (ASP) activity on the usage pattern of antibiotics.

Methods

An interrupted time-series analysis assessing the trends in antibiotic use was conducted between September 2015 and August 2019 in an 859-bed university-affiliated hospital in Korea, where all ASP activities were discontinued in March 2018. The major activity of the ASP was a restrictive antibiotic programme.

Results

The use of restrictive antibiotics increased immediately after the discontinuation of the ASP by 41.06 days of therapy (DOT)/1000 patient-days in the general ward (95% confidence interval (CI) 21.04–61.08) and by 391.04 DOT/1000 patient-days in the intensive care unit (ICU) (95%CI 207.56–574.51). In addition, there were positive changes in the slope for the use of restrictive antibiotics in the general ward (7.06 DOT/1000 patient-days per month, 95%CI 4.63–9.50) and ICU (35.95 DOT/1000 patient-days per month, 95%CI 18.70–53.19). The use of broad-spectrum antibiotics in the general ward significantly decreased (–87.54 DOT/1000 patient-days, 95%CI –149.29 to –25.79). For non-broad-spectrum antibiotics, there were positive changes in the slope in the general ward (16.54 DOT/1000 patient-days per month, 95%CI 12.99–20.09) and ICU (12.85 DOT/1000 patient-days per month, 95%CI 2.32–23.38).

Conclusions

After discontinuation of the ASP, antibiotic usage patterns rapidly returned to the patterns prior to the implementation of the programme.

中文翻译：

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终止抗菌药物管理计划对抗生素使用模式的影响

目标

本研究旨在分析终止抗菌药物管理计划 (ASP) 活动对抗生素使用模式的影响。

方法

2015 年 9 月至 2019 年 8 月期间，在韩国一家拥有 859 个床位的大学附属医院进行了评估抗生素使用趋势的中断时间序列分析，该医院的所有 ASP 活动于 2018 年 3 月停止。ASP 的主要活动是限制性抗生素计划。

结果

在普通病房停止 ASP 后，限制性抗生素的使用立即增加了 41.06 天 (DOT)/1000 患者天（95% 置信区间 (CI) 21.04-61.08）和 391.04 DOT/1000 患者-重症监护病房 (ICU) 的天数 (95%CI 207.56–574.51)。此外，普通病房（每月 7.06 DOT/1000 患者日，95%CI 4.63-9.50）和重症监护室（每月 35.95 DOT/1000 患者日）使用限制性抗生素的斜率也有正向变化, 95%CI 18.70–53.19)。普通病房中广谱抗生素的使用显着减少（–87.54 DOT/1000 患者日，95%CI –149.29 至 –25.79）。对于非广谱抗生素，普通病房（16.54 DOT/1000病日/月，95%CI 12.99-20.09）和ICU（12.

结论

停止 ASP 后，抗生素使用模式迅速恢复到项目实施前的模式。