Comparison between antimicrobial stewardship program and intervention by infection control team for managing antibiotic use in neurogenic bladder-related urinary tract infection patients: A retrospective chart audit
Abstract
BACKGROUND
Antimicrobial prescriptions are relatively common in urologic outpatients. Therefore, it is necessary to investigate the impact of antimicrobial stewardship program (ASP) interventions.
METHODS
In urology outpatients, antimicrobial use density (AUD), antimicrobial agent costs, isolation of urinary tract infection (UTI)-causing organisms and their antimicrobial susceptibilities were compared between intervention by infection control team (ICT) era (pre-2014) and ASP era (post-2014) in 2739 patients with lower urinary tract symptoms, including neurogenic bladder patients with UTI or suspected UTI, from 2011 to 2020.
RESULTS
In the ASP, overall AUD (p<0.001), cefotiam (CTM) (p=0.0013), 2nd-generation cephalosporins (p=0.026), cefdinir (CFDN) (p<0.001), levofloxacin (LVFX) (p<0.001), sitafloxacin (STFX) (p=0.0016), and tosufloxacin (TFLX) (p=0.0044) showed a significant decrease, but cefaclor (p=0.019) showed a significant increase. Regarding antimicrobial agent costs, overall (p = 0.016), CTM (p=0.021), 2nd-generation cephalosporins (p=0.033), CFDN (p=0.016), LVFX (p=0.016), STFX (p=0.033), and TFLX (p=0.033) showed a significant decrease in the ASP. UTI-causing antimicrobial susceptibilities, CTM (p = 0.035), LVFX (p = 0.026) and sulfamethoxazole/trimethoprim (p = 0.048) in E. coli, and minocycline (p = 0.026) in K. pneumoniae showed a significant improve in the ASP.
CONCLUSION
ASP contributed to decrease AUD and antimicrobial agent costs, and to improve…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 2,739 participants or records.
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