Antimicrobial stewardship program in one primary care hospital, a snapshot analysis

Abstract Antimicrobic resistance (AMR) continues to rise, whereas development of new agents to counter it has slowed. A heightened need to maintain the effectiveness of currently available agents exists. Healthcare-associated infections (HAIs) are a significant cause of poor treatment outcomes and elevated healthcare and societal costs worldwide. At the beginning of 2024, we started a prospective, interventional, interrupted time-series study, based on Prospective Audit and Feedback in the Intensive Care Unit (ICU) and in the internal medicine ward of our hospital. The primary outcomes will be the difference in the antibiotic consumption, and the incidence of bloodstream infections (BSI) caused by multidrug-resistant (MDR) organisms. The secondary outcomes will include the hospital mortality rate, the mean length of stay and the antibiotic expense. We conducted a snapshot analysis of the first three months to assess the efficacy our program. In the first three months we registered a global reduction in antibiotic expense (almost by half in comparison of 2023 first quarter) and consumption, particularly in the use of carbapenems: (change in level, CL: -51,26 DDD/1000 PD,) and third- generation cephalosporins (CL: -6 DDD/1000 PD). We registered a reduction in the use of hydroalcoholic gel, probably due to the reducted perception after the waning of risk perception towards Covid-19, although no big difference was observed in BSI incidence due to MDR Gram-negative organisms (CL: +1,2 events/1000 PD). Albeit partial, once again these findings demonstrated that implementation of an antimicrobial stewardship program, no matter the level of healthcare, is critical for fighting the AMR and to lessen the burden on Public Health; in particular our program induced a significant reduction in antibiotic consumption that lead to more funds at disposal to improve our clinical practice. Key messages • Once again our findings demonstrated that implementation of an antimicrobial stewardship, no matter the level of healthcare, is critical for fighting the AMR. • Our program induced a significant reduction in antibiotic consumption.