Effect of an Intensified Antibiotic Stewardship Program at an Orthopedic Surgery Department.

Feihl, Susanne; Querbach, Christiane; Hapfelmeier, Alexander; Busch, Dirk H; von Eisenhart-Rothe, Rüdiger; Gebhardt, Friedemann; Pohlig, Florian; Mühlhofer, Heinrich M L

doi:10.1089/sur.2021.040

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2022

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Title:: Effect of an Intensified Antibiotic Stewardship Program at an Orthopedic Surgery Department.
Document type:: Article; Journal Article
Author(s):: Feihl, Susanne; Querbach, Christiane; Hapfelmeier, Alexander; Busch, Dirk H; von Eisenhart-Rothe, Rüdiger; Gebhardt, Friedemann; Pohlig, Florian; Mühlhofer, Heinrich M L
Abstract:: Background: Institutional programs such as antibiotic stewardship (ABS) programs offer possibilities to monitor and modify antibiotic usage with the aim of reducing antibiotic resistance. In orthopedic units that treat peri-prosthetic joint infections (PJIs), ABS programs are still rare, however, there is extensive use of high-risk antibiotic agents and an increased risk for the occurrence of Clostridium difficile infections (CDIs). Patients and Methods: An ABS program was implemented at the Department of Orthopedic Surgery at a university hospital. Quarterly antibiotic consumption was measured in defined daily doses (DDDs) per 100 patient-days (PDs) at 10 quarters before the intervention and seven quarters after the intervention. The effect of the new antibiotic policy on drug use rates was evaluated using an interrupted time-series analysis. Estimated changes over time in the incidence of CDIs (cases per 1,000 PDs) were analyzed. Results: A remarkable percentual reduction in second-generation cephalosporin use of 83% (p < 0.001; pre-intervention level, 81.486 DDDs/100 patient-days; post-intervention level, 13.751 DDDs/100 PDs) and clindamycin administration of 78% (p < 0.001; pre-intervention level, 18.982 DDDs/100 PDs; post-intervention level, 4.216 DDDs/100 PDs) was observed after implementation of ABS interventions. Total antibiotic use declined by 25% (p < 0.001; pre-intervention level, 129.078 DDDs/100 PDs; post-intervention level, 96.826 DDDs/100 PDs). Conclusions: This research assessed the positive impact of an intensified ABS program at an orthopedic department specializing in PJIs. Antibiotic stewardship program interventions encourage the reduction of total antibiotic usage and especially high-risk antibiotic agents, associated with the development of antimicrobial resistance.
Journal title abbreviation:: Surg Infect (Larchmt)
Year:: 2022
Journal volume:: 23
Journal issue:: 2
Pages contribution:: 105-112
Fulltext / DOI:: doi:10.1089/sur.2021.040
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/34762545
Print-ISSN:: 1096-2964
TUM Institution:: Institut für KI und Informatik in der Medizin; Institut für Medizinische Mikrobiologie, Immunologie und Hygiene; Klinik und Poliklinik für Orthopädie und Sportorthopädie
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mediaTUM Gesamtbestand Hochschulbibliographie 2022 Schools und Fakultäten Medizin Institut für Medizinische Mikrobiologie, Immunologie und Hygiene

mediaTUM Gesamtbestand Hochschulbibliographie 2022 Schools und Fakultäten Medizin Institut für Medizinische Statistik und Epidemiologie

mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Preclinical Medicine Institut für Medizinische Mikrobiologie, Immunologie und Hygiene (Prof. Busch)2022

mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Klinik und Poliklinik für Orthopädie und Sportorthopädie (Prof. von Eisenhart-Rothe)2022

mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Institut für KI und Informatik in der Medizin (Prof. Rückert)2022

mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Institut für KI und Informatik in der Medizin (Prof. Rückert)Lehrstuhl für Medizinische Informatik (Prof. Boeker)2022