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dc.contributor.authorGarcía Rodríguez, José Francisco 
dc.contributor.authorBardán García, Belén 
dc.contributor.authorPeña Rodríguez, María Fernanda 
dc.contributor.authorÁlvarez Díaz, Hortensia 
dc.contributor.authorMariño Callejo, Ana Isabel 
dc.date.accessioned2019-01-22T12:14:25Z
dc.date.available2019-01-22T12:14:25Z
dc.date.issued2018-10-26
dc.identifier.issn0934-9723
dc.identifier.otherhttps://www.antimicrobialstewardship.net/feed-items/meropenem-antimicrobial-stewardship-program-clinical-economic-and-antibiotic-resistance-impact/es
dc.identifier.otherhttps://www.researchgate.net/publication/328549130_Meropenem_antimicrobial_stewardship_program_clinical_economic_and_antibiotic_resistance_impactes
dc.identifier.urihttp://hdl.handle.net/20.500.11940/11484
dc.description.abstractBackground. There are few prospective studies with sufficient duration in time to evaluate clinical and antibiotic resistance impact of Antibiotic Stewardship Programs (ASP). Methods. Descriptive study between January-2012 to December-2017, pre-postintervention. An meropenem ASP was initiated in January 2015, in patients who started treatment with meropenem an infectious diseases physician performed treatment recommendations to prescribers. Prospective information was collected to evaluate adequacy of meropenem prescription to local guidelines and to compare results between cases with accepted or rejected intervention. Analysis was performed to verify variables associated with intervention acceptance and with any significant change in meropenem consumption, hospital-acquired multidrug-resistant (MDR) bloodstream infections (BSIs) and 30-day all-cause crude death in MDR BSIs. Results. Adequacy of meropenem prescription and de-escalation from meropenem treatment to narrower-spectrum antibiotic improved progressively over time, after ASP implementation (p<0.001). Interventions on prescription were performed in 330 (38.7%) patients without meropenem justified treatment, in 269 intervention was accepted and in 61 not. Intervention acceptance was associated with shorter duration of treatment, cost and inpatient days (p<0.05); intervention rejection was not associated with severity of patient. During the period 2015-2017, meropenem consumption decreased compared with 2012-2014 [Rate ratio (RR) 0.67; 95%CI: 0.58- 0.77, p<0.001]). Likewise decreased, hospital-acquired MDR BSIs rate (RR 0.63; 95%CI: 0.38-1.02, p=0,048) and 30-day all-cause crude death in MDR BSIs (RR 0.45; 95%CI: 0.14-1.24, p=0.09), coinciding in time with ASP start-up. Conclusions. The decrease and better use of meropenem achieved had a sustained clinical, economic and ecological impact, reducing costs and mortality of hospital acquired MDR BSIs.es
dc.language.isoenges
dc.subject.meshCarbapenems *
dc.subject.meshDrug Resistance, Microbial *
dc.subject.meshCross Infection *
dc.titleMeropenem antimicrobial stewardship program: clinical, economic, and antibiotic resistance impactes
dc.typeArtigoes
dc.rights.holderSpringer Nature Switzerland AG. Part of Springer Nature.es
dc.bbddEmbase*
dc.bbddWOK*
dc.identifier.essn1435-4373
dc.identifier.pmid30367313
dc.issue.number1es
dc.journal.titleEuropean Journal of Clinical Microbiology & Infectious Diseaseses
dc.organizationServizo Galego de Saúde::Estrutura de Xestión Integrada (EOXI)::EOXI de Ferrol – Complexo Hospitalario Universitario de Ferrol::Medicina Internaes
dc.organizationServizo Galego de Saúde::Estrutura de Xestión Integrada (EOXI)::EOXI de Ferrol – Complexo Hospitalario Universitario de Ferrol::Farmaciaes
dc.organizationServizo Galego de Saúde::Estrutura de Xestión Integrada (EOXI)::EOXI de A Coruña - Complexo Hospitalario Universitario de A Coruña ::Análise clínicoses
dc.page.initial161es
dc.page.final170es
dc.relation.publisherversionhttps://link.springer.com/article/10.1007/s10096-018-3408-2es
dc.rights.accessRightsopenAccesses
dc.subject.decsinfección hospitalaria *
dc.subject.decscarbapenems *
dc.subject.decsfarmacorresistencia microbiana *
dc.subject.keywordAntimicrobial stewardshipes
dc.subject.keywordmultidrug-resistantes
dc.subject.keywordhospital infectionses
dc.subject.keywordbloodstream infectionses
dc.subject.keywordcarbapenemses
dc.typefidesArtigo Científico (inclue Orixinal, Orixinal breve, Revisión Sistemática e Meta-análisis)es
dc.typesophosArtículo Originales
dc.volume.number38es


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