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Article

Defining the Scope of Antimicrobial Stewardship Interventions on the Prescription Quality of Antibiotics for Surgical Intra-Abdominal Infections

1
Department of Infection Control and Antimicrobial Stewardship, University Hospital of Würzburg, 97080 Würzburg, Germany
2
Institute of Hygiene and Microbiology, University of Würzburg, 97080 Würzburg, Germany
3
Department of General-, Visceral-, Transplant-, Vascular- and Paediatric Surgery, University Hospital of Würzburg, 97080 Würzburg, Germany
*
Author to whom correspondence should be addressed.
Received: 29 December 2020 / Revised: 8 January 2021 / Accepted: 11 January 2021 / Published: 14 January 2021
Background: The aim of this study was to assess the impact of antimicrobial stewardship interventions on surgical antibiotic prescription behavior in the management of non-elective surgical intra-abdominal infections, focusing on postoperative antibiotic use, including the appropriateness of indications. Methods: A single-center quality improvement study with retrospective evaluation of the impact of antimicrobial stewardship measures on optimizing antibacterial use in intra-abdominal infections requiring emergency surgery was performed. The study was conducted in a tertiary hospital in Germany from January 1, 2016, to January 30, 2020, three years after putting a set of antimicrobial stewardship standards into effect. Results: 767 patients were analyzed (n = 495 in 2016 and 2017, the baseline period; n = 272 in 2018, the antimicrobial stewardship period). The total days of therapy per 100 patient days declined from 47.0 to 42.2 days (p = 0.035). The rate of patients receiving postoperative therapy decreased from 56.8% to 45.2% (p = 0.002), comparing both periods. There was a significant decline in the rate of inappropriate indications (17.4% to 8.1 %, p = 0.015) as well as a significant change from broad-spectrum to narrow-spectrum antibiotic use (28.8% to 6.5%, p ≤ 0.001) for postoperative therapy. The significant decline in antibiotic use did not affect either clinical outcomes or the rate of postoperative wound complications. Conclusions: Postoperative antibiotic use for intra-abdominal infections could be significantly reduced by antimicrobial stewardship interventions. The identification of inappropriate indications remains a key target for antimicrobial stewardship programs. View Full-Text
Keywords: antimicrobial stewardship; antibiotic prescription behavior; surgical intra-abdominal infections; post-operative antibiotic treatment antimicrobial stewardship; antibiotic prescription behavior; surgical intra-abdominal infections; post-operative antibiotic treatment
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MDPI and ACS Style

Surat, G.; Vogel, U.; Wiegering, A.; Germer, C.-T.; Lock, J.F. Defining the Scope of Antimicrobial Stewardship Interventions on the Prescription Quality of Antibiotics for Surgical Intra-Abdominal Infections. Antibiotics 2021, 10, 73. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics10010073

AMA Style

Surat G, Vogel U, Wiegering A, Germer C-T, Lock JF. Defining the Scope of Antimicrobial Stewardship Interventions on the Prescription Quality of Antibiotics for Surgical Intra-Abdominal Infections. Antibiotics. 2021; 10(1):73. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics10010073

Chicago/Turabian Style

Surat, Güzin, Ulrich Vogel, Armin Wiegering, Christoph-Thomas Germer, and Johan F. Lock 2021. "Defining the Scope of Antimicrobial Stewardship Interventions on the Prescription Quality of Antibiotics for Surgical Intra-Abdominal Infections" Antibiotics 10, no. 1: 73. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics10010073

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