2014, Number 1
<< Back Next >>
Revista Cubana de Cirugía 2014; 53 (1)
Implementation of an antibiotic stewardship program at hospital and its economic impact
Pisonero SJJ, Guanche GH, Mir NI, Enseñat SR, Fiterre LI, García AB
Language: Spanish
References: 14
Page: 52-59
PDF size: 206.64 Kb.
ABSTRACT
Introduction: the implementation of antibiotic stewardship programs has proved to be useful to monitor the microbial resistance and, in addition to other advantages, it has considerable economic impact on the health management.
The objective of this research work was to describe the economic impact of an antibiotic stewardship program.
Methods: an intervention study was conducted in "Joaquin Albarran" hospital from May 2008 to December 2011. The net cost of the use of antimicrobials (by selected
family and drugs) and the monthly mean for annual periods were estimated. A simple regression method was used to explore the changes in net costs.
Results: the costs were 3 763 903 Cuban pesos, and from August 2009 to December 2011 (mean 70 267.6 Cuban pesos) there was a decline in monthly mean costs by 40 % (- 46 215.6 Cuban pesos monthly) and significant reduction in
total and average costs in the study period (p ‹ 0.001). Cephalosporins and fluoroquinolones accounted for the highest proportion of costs due to the use of antimicrobials (52.5 % and 32.8 %, respectively. Additionally, there was significant decrease in the nosocomial infection rates (p ‹ 0.001), but changes in the mortality rates were not remarkable.
Conclusions: the implementation of an antibiotic stewardship program at hospital had a positive effect since it reduced the costs of the use of antimicrobials. The implementation of similar programs is recommended in hospitals, using customized strategies pursuant to the characteristics of each institution.
REFERENCES
Dellit TH, Owens RC, McGowan JE, Gerding DN, Weinstein RA, Burke JP, et al. Infectious Diseases Society of America and the Society for Health care Epidemiology of America guidelines for developing an institutional program to enhance antimicrobial stewardship. Clin Infect Dis. 2007;44(2):159-77.
Septimus EJ, Owens RC. Need and potential of antimicrobial stewardship in community hospital. Clin Infect Dis. 2011;53(S1):S8-S14.
Malani AN, Richards PG, Kapila S, Otto MH, Czerwinski J, Singal B. Clinical and economic outcomes from a community hospital´s antimicrobial stewardship program. Am J Infect Control. 2013;41(2):145-8.
Sweileh WM, Adas SO, Sawalha AF, Abu Taha SA. Utilization and cost of antibacterial drugs in 2 general surgery units in Palestine measureusing anatomical therapeutic chemical classification and defined daily dose methodology. EMHJ. 2012;18(6):641-6.
Mir Narbona I, Guanche Garce H, Chappi Estévez Y, Díaz Piñera A, Rodríguez Uribe S, Fiterre Lancis I, et al. Calidad de prescripción de antimicrobianos en servicios seleccionados en hospitales clínico quirúrgicos. AVFT. 2009;28(2):63-5.
Guanche Garcell H, Reyes Arencibia R, Pardo Gómez G, Pisonero Socías JJ. Profilaxis perioperatoria en cirugía urológica en hospitales cubanos. Rev Cubana Cir. 2011;50(4):413-22.
Guanche Garcell H, Izquierdo-Cubas F, Zambrano A, Frómeta I, Bastanzuri Pagés M, Malpica Dib J, Rodríguez D, Gutiérrez García F. Uso de antimicrobianos en instituciones de salud de Cuba. MediCrit 2009;6(1).
Nathwani D, Sneddon J, Patton A, Malcom W. Antimicrobial stewardship in Scotland: impact of a national programme. Antimic. Resist Infect Control. 2012;1:7.
Tseng SH, Lee CM, LinTY, Chang SC, Chuang YC, Yen MY, et al. Combating antimicrobial resistance: antimicrobial stewardship program in Taiwan. J Microbiol Immunol Infect. 2012;45:79-89.
Guanche Garcell H, Pisonero Socias JJ, Enseñat Sánchez R, Fiterre Lancis I, Mir Narbona I, García Arzola B, et al. Impacto de un programa de control de la calidad de la prescripción de antibióticos en un hospital de La Habana, Cuba. Rev Panam Salud Pública. 2011;30(6):598-602.
Storey DF, Pate PG, Nguyen ATT, Chang F. Implementation of anantimicrobial stewardship program on the medical-surgical service of a 100 bed community hospital. Antimic. Resist Infect Control. 2012;32.
Standiford HC, Chan S, Tripoli M, Weekes E, Forrest GN. Antimicrobial stewardship at a large tertiary care academic medical center: cost analysis before, during and after a 7 year program. Infect Control Hosp Epidemiol. 2012;33(4):338-45.
Teo J, Kwa LH, Loh J, Chlebicki MP, Lee W. The effect of a whole system approach in an antimicrobial stewardship programme at the Singapore General Hospital. Eur J Clin Infect Dis .2012;31:947-55.
Ohl CA, Dodds Ashley ES. Antimicrobial stewardship programs in community hospitals: evidence base and case studies. Clin Infect Dis. 2011;53(S1):S23-8.