Clinical and Epidemic Outcomes from Implementation of Hospital-Based Antimicrobial Stewardship Programmes (ASPs)

The poor authors of this study had to read 24,917 citations to locate 26 studies with pre- and post-implementation comparisons.[1] The mean effect across these 26 ASPs was a 19% reduction in total antimicrobial consumption, while there was a 27% reduction in use of ‘restricted’ antibiotic agents, and an 18.5% reduction in use of broad-spectrum antibiotics. Overall hospital costs decreased by no less than 34% (mainly due to a 9% reduction in length of stay). There was a reduction in infections with resistant organisms, but no overall reduction in infection related adverse events. Of course, the interventions varied in nature and there was no attempt to classify them (say by type and intensity of intervention) and analyse the results accordingly. The study designs are generally weak, not controlling for temporal trends. The health economics is short-term and (for understandable reasons) the potential benefits of a contingent decrease in antimicrobial resistance were not modelled.

— Richard Lilford, CLAHRC WM Director

Reference:

  1. Karanika S, Paudel S, Grigoras C, Kalbasi A, Mylonakis E. Systematic Review and Meta-analysis of Clinical and Economic Outcomes from the Implementation of Hospital-Based Antimicrobial Stewardship Programs. Antimicrob Agents Chemother. 2016; 60(8): 4840-52
Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s