Impact of Antimicrobial Stewardship Programs in Latin American Adult Intensive Care Units: PROA-LATAM Project. (October 2020)

• Record Type: Journal Article
• Authors: Quirós, Rodolfo; Angeleri, Patricia; Zurita, Jeannete; Aleman, Washington; Carneiro, Marcelo; Guerra, Silvia; Medina, Julio; Luquerna, Ximena Castañda; Guerra, Alexander; Vega, Silvio; Cuéllar, Luis; Munita, Jose; Maki, Gina; Prentiss, Tyler; Escobar, Elvio; Foianini, Ángel; Zervos, Marcus; Bardossy, Ana
• Is Part Of: Infection control and hospital epidemiology. Volume 41(2020)Supplement 1
• Page Start: s520
• Page End: s520
• Publication Date: 2020-10
• Subjects: Nosocomial infections -- Epidemiology -- Periodicals; Health facilities -- Sanitation -- Periodicals; Hospital buildings -- Sanitation -- Periodicals; Cross Infection -- Periodicals; Epidemiology -- Periodicals; Hospitals -- Periodicals; Infection Control -- Periodicals; 614.44
• DOI: 10.1017/ice.2020.1203
• Languages: English
• ISSNs: 0899-823X

Abstract

Abstract : Background: Antimicrobial stewardship programs (ASPs) are useful in improving clinical outcomes in a cost-effective way and in reducing antimicrobial resistance. Objective: We sought to determine the impact of ASP in adult medical-surgical intensive care units (MS-ICUs). Methods: A multicenter study, in 77 MS-ICUs of 9 Latin-American countries, was conducted along 12 months (July 2018–June 2019). A self-assessment survey using a tool based on CDC recommendations (0–100 scale) was performed at the beginning, after 6 months, and at the end of the study. The impact of ASP was evaluated monthly using the following indicators: antimicrobial consumption (defined daily doses [DDD] per 100 patient days), appropriateness of antimicrobial prescriptions (percentage of total prescriptions), crude mortality rate (events per 100 discharges), and hospital-acquired multidrug-resistant microorganisms (MDRs) and Clostridioides difficile infections (CDI events per 1, 000 patient days). These indicators were compared between MS-ICUs that reached the 75th percentile and those that maintained the 25th percentile at the final self-assessment. Results: Of all indicators evaluated, only surgical prophylaxis ≤24 hours, vancomycin therapeutic monitoring, and aminoglycosides (1 dose per day) did not show significant differences between MS-ICUs at the 75th percentile and the 25th percentile. CDI events were significantly higher at the 75th percentile MS-ICUs, probably related to better detection of C. difficile (Table 1). Conclusions: This study confirmed that MS-ICUs with more comprehensive ASPs had significantly better indicators. Funding: Proprietary Organization: MERCK Disclosures: None