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Impact of an antimicrobial stewardship programme on antimicrobial consumption and cost in an Italian hospital

Abstract number: R2145

Pagani L., Falciani M., Aschbacher R., Spoladore G., Larcher C., Mian P.

Objective: To evaluate the impact of an Antimicrobial Stewardship Program (ASP) on consumption and cost of antimicrobials.

Methods: from January 2008, an ASP has been carried out in our 1400-bed referral hospital in the North-Eastern Italy by ID consultants, pharmacists and microbiologists, who constitute the Antimicrobial Management Team (AMT). Antimicrobial formulary restrictions (mainly concerning broad spectrum- and last generation-antibiotics), microbiologically-driven empirical and targeted therapies, and regular educational meetings were the most important interventions implemented. We initially analyzed two surgical and three medical wards (vascular/thoracic surgery, urology, 2 internal medicine divisions and pneumology). Defined daily doses (DDD)/100 bed-days consumption pooled data were analyzed through the ESGAP ABC Calc 3.1b program for the year 2008. These data were then compared to the same data of 2007, in which the ASP had not yet been implemented.

Results: a remarkable decrease of restricted antimicrobials consumption has been observed between the two years, whereas a comparable trend was not detected for freely available drugs. Moreover, drug acquisition costs strongly decreased. The main results are summarised in the table, where "*" indicates some of the restricted antimicrobials at our institution.

Conclusions: although preliminary and concerning a limited number of wards of our hospital, these data strongly support the need for a multidisciplinary approach to antimicrobial therapy at institutional level to decrease antimicrobial pressure and to control expenditures. Through the regular activity of the AMT, this integrated approach may also affect the appropriateness of antimicrobial prescription within the whole hospital.

AntibacterialDDDEUR
 20072008200720082007/2008
Cefuroxime3,092.33,125.017,228.7317,048.64-180.09
Cefotaxime3,026.02,482.014,777.697,374.42-7,403.27
Ceftazidime*354.8163.86,319.772,819.37-3,500.40
Cefepime*105.08.0919.2569.99-849.26
Meropenem*410.0126.817,343.495,422.43-11,921.06
Imipenem/enzyme inhibitor375.8202.816,307.818,652.44-7,655.37
Ciprofloxacin1,655.21,702.855,725.9244,533.39-11,192.53
Levofloxacin2,758.03,479.072,583.3391,820.62+19,237.29
Vancomycin*341.3199.32,592.071,402.68-1,189.39
Teicoplanin*501.0195.518,070.017,079.17-10,990.84
Total  221,868.07186,223.15-35,644.92

Session Details

Date: 16/05/2009
Time: 00:00-00:00
Session name: 19th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Helsinki, Finland, 16 - 19 May 2009
Presentation type:
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