Favorable Impact of a Multidisciplinary Antibiotic Management Program Conducted During 7 Years

作者：Philip Carling, Teresa T. Fung, Ann Killion, Norma C. Terrin, Michael J. Barza · 发表于：Infection Control and Hospital Epidemiology · 年份：2003 · DOI：10.1086/502278 · 被引用次数：408 · 研究领域：Antibiotic Use and Resistance、Surgical site infection prevention、Nosocomial Infections in ICU

OBJECTIVE: To evaluate the impact of an interventional multidisciplinary antibiotic management program on expenditures for antibiotics and on the incidence of nosocomial infections caused by Clostridium difficile and antibiotic-resistant pathogens during 7 years. DESIGN: Prospective study with comparison with preintervention trends. SETTING: University-affiliated teaching hospital. PATIENTS: All adult inpatients. INTERVENTION: A multidisciplinary antibiotic management program to minimize the inappropriate use of third-generation cephalosporins was implemented in 1991. Its impact was evaluated prospectively. The incidence of nosocomial C. difficile and resistant Enterobacteriaceae infections as well as the rate of vancomycin-resistant enterococci (VRE) and methicillin-resistant Staphylococcus aureus (MRSA) were compared with those of National Nosocomial Infections Surveillance System hospitals of similar size. RESULTS: Following implementation of the program, there was a 22% decrease in the use of parenteral broad-spectrum antibiotics (P < .0001) despite a 15% increase in acuity of patient care during the following 7 years. Concomitantly, there was a significant (P = .002) decrease in nosocomial infections caused by C. difficile and a significant (P = .02) decrease in nosocomial infections caused by resistant Enterobacteriaceae. The program also appeared to have a favorable impact on VRE rates without a sustained impact on MRSA rates. CONCLUSION: These results suggest that an ...