Impact of antimicrobial stewardship programs on antibiotic consumption and antimicrobial resistance in four Colombian healthcare institutions

Christian Pallares, Cristhian Hernández-Gómez, Tobías Manuel Appel, Kevin Escandón, Sergio Reyes, Soraya Salcedo, Lorena Matta, Ernesto Martínez, Sara Cobo, Laura Mora, Adriana Marín, Adriana Correa, Elsa De La Cadena, Jesús Rodríguez-Baño, María Virginia Villegas

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background
Antimicrobial stewardship programs (ASPs) have become a fundamental pillar in optimizing antimicrobial usage, improving patient care, and reducing antimicrobial resistance (AMR). Herein we evaluated the impact of an ASP on antimicrobial consumption and AMR in Colombia.
Methods
We designed a retrospective observational study and measured trends in antibiotic consumption and AMR before and after the implementation of an ASP using interrupted time series analysis over a 4-year period (24 months before and 24 months after ASP implementation).
Results
ASPs were implemented according to the available resources in each of the institutions. Before ASP implementation, there was a trend toward an increase in the antibiotic consumption of all measured antimicrobials selected. Afterward, an overall decrease in antibiotic consumption was observed. The use of ertapenem and meropenem decreased in hospital wards, while a decrease in the use of ceftriaxone, cefepime, piperacillin/tazobactam, meropenem, and vancomycin was observed in intensive care units. After ASP implementation, the trend toward an increase of oxacillin-resistant Staphylococcus aureus, ceftriaxone-resistant Escherichia coli, and meropenem-resistant Pseudomonas aeruginosa was reversed.
Conclusions
In our study, we showed that ASPs are a key strategy in tackling the emerging threat of AMR and have a positive impact on antibiotic consumption and resistance.
Original languageEnglish (US)
Article number420
JournalBMC infectious diseases
Volume22
Issue number1
DOIs
StatePublished - Dec 2022

Bibliographical note

Funding Information:
This study was conducted with the support of a research grant from Merck Sharp & Dohme Colombia (2015). The sponsor had no role in the study design, data collection, statistical analysis, decision to publish, and manuscript preparation.

Publisher Copyright:
© 2022, The Author(s).

Keywords

  • Antibiotic resistance
  • Antimicrobial resistance
  • Antimicrobial stewardship
  • Antimicrobial stewardship program
  • Colombia
  • Hospital epidemiology

PubMed: MeSH publication types

  • Journal Article
  • Observational Study

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