Impact of Implementing an Outpatient Antimicrobial Stewardship Program on Urinary Tract Infection Management in a Private Hospital in Costa Rica
Abstract
Background: Antimicrobial stewardship programs (AMS) improve antibiotic use in both hospital and outpatient (OP) settings. While AMS initiatives in Latin America have focused mainly on inpatient care, OP-specific interventions remain limited. Hospital Clínica Bíblica (HCB) had an AMS program for hospital settings but lacked structured OP activities. Objectives: To evaluate the implementation of an AMS-OP in a private hospital in Costa Rica, its impact on antibiotic prescribing patterns for urinary tract infections (UTIs), and its feasibility for broader application in the Latin American context. Methods: A retrospective observational study with a pre- and post-intervention design was conducted. The analysis compared OP antibiotic prescribing for UTIs during the pre-AMS-OP period (July 2021-March 2022) and the post-AMS-OP period (July-December 2022). The AMS-OP was implemented from April to June 2022. Baseline compliance with CDC AMS-OP elements was assessed. A total of 269 OP UTI cases were analyzed, focusing on optimal antibiotic selection, physician adherence to clinical guidelines, and clinical outcomes, including recurrence and relapse. Results: UTIs accounted for 163 (40.1%) of 407 OP antibiotic prescriptions. Pre-AMS-OP, 255 (62.7%) of the antibiotics prescribed belonged to the WHO Watch category. Post-AMS-OP, CDC compliance increased from 28.6% to 85.7%. Optimal antibiotic selection improved from 143 (53.8%) to 126 (95.2%) cases (p < 0.001). The optimal use of…
Read the paper
Related studies
- Association of lower urinary tract symptoms and OAB severity with quality of life and mental health in China, Taiwan and South Korea: results from a cross-sectional, population-based study
- Ten-Day Quadruple Therapy Comprising Low-Dose Rabeprazole, Bismuth, Amoxicillin, and Tetracycline Is an Effective and Safe First-Line Treatment for Helicobacter pylori Infection in a Population with High Antibiotic Resistance: a Prospective, Multicenter, Randomized, Parallel-Controlled Clinical Trial in China
- The Role of the NLR and PLR in Urinary Tract Infection
- Threat of Antimicrobial Resistance among Pilgrims with Infectious Diseases during Hajj: Lessons Learnt from COVID-19 Pandemic
- Leclercia adecarboxylata urinary tract infection in a patient with bladder cancer and recurrent hematuria
- A Case Series of Staphylococcus lugdunensis Infection in Cancer Patients at an Academic Cancer Institute in the United States
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.