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. 2021 Jan 19;10(1):93.
doi: 10.3390/antibiotics10010093.

Implementation of Antibiotic Stewardship in a University Hospital Setting

Milan Kolar  1 , Miroslava Htoutou Sedlakova  1 , Karel Urbanek  2 , Patrik Mlynarcik  1 , Magdalena Roderova  1 , Kristyna Hricova  1 , Kristyna Mezerova  1 , Pavla Kucova  1 , Jana Zapletalova  3 , Katerina Fiserova  1 , Pavel Kurfurst  4
Affiliations

Implementation of Antibiotic Stewardship in a University Hospital Setting

Milan Kolar et al. Antibiotics (Basel). .

Abstract

The article describes activities of an antibiotic center at a university hospital in the Czech Republic and presents the results of antibiotic stewardship program implementation over a period of 10 years. It provides data on the development of resistance of Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and Staphylococcus aureus to selected antibiotic agents as well as consumption data for various antibiotic classes. The genetic basis of resistance to beta-lactam antibiotics and its clonal spread were also assessed. The study showed significant correlations between aminoglycoside consumption and resistance of Escherichia coli and Klebsiella pneumoniae to gentamicin (r = 0.712, r = 0.869), fluoroquinolone consumption and resistance of Klebsiella pneumoniae to ciprofloxacin (r = 0.896), aminoglycoside consumption and resistance of Pseudomonas aeruginosa to amikacin (r = 0.716), as well as carbapenem consumption and resistance of Pseudomonas aeruginosa to meropenem (r = 0.855). Genotyping of ESBL- positive isolates of Klebsiella pneumoniae and Escherichia coli showed a predominance of CTX-M-type; in AmpC-positive strains, DHA, EBC and CIT enzymes prevailed. Of 19 meropenem-resistant strains of Klebsiella pneumoniae, two were identified as NDM-positive. Clonal spread of these strains was not detected. The results suggest that comprehensive antibiotic stewardship implementation in a healthcare facility may help to maintain the effectiveness of antibiotics against bacterial pathogens. Particularly beneficial is the work of clinical microbiologists who, among other things, approve administration of antibiotics to patients with bacterial infections and directly participate in their antibiotic therapy.

Keywords: antibiotic stewardship; clonal spread; consumption of antibiotics; resistance.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Correlation between aminoglycoside consumption (in numbers of defined daily doses) and resistance of Escherichia coli to gentamicin.
Figure 2
Figure 2
Correlation between fluoroquinolone consumption (in numbers of defined daily doses) and resistance of Klebsiella pneumoniae to ciprofloxacin.
Figure 3
Figure 3
Correlation between aminoglycoside consumption (in numbers of defined daily doses) and resistance of Pseudomonas aeruginosa to amikacin.
Figure 4
Figure 4
Correlation between aminoglycoside consumption (in numbers of defined daily doses) and resistance of Klebsiella pneumoniae to gentamicin.
Figure 5
Figure 5
Correlation between carbapenem consumption (in numbers of defined daily doses) and resistance of Pseudomonas aeruginosa to meropenem.
See this image and copyright information in PMC

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References

    1. Dyar O.J., Huttner B., Schouten J., Pulcini C. ESGAP (ESCMID Study Group for Antimicrobial stewardshiP). What is antimicrobial stewardship? Clin. Microbiol. Infect. 2017;23:793–798. doi: 10.1016/j.cmi.2017.08.026. - DOI - PubMed
    1. Srinivasan A. Antibiotic stewardship: Why we must, how we can. Clevel. Clin. J. Med. 2017;84:673–679. doi: 10.3949/ccjm.84gr.17003. - DOI - PMC - PubMed
    1. Luyt C.E., Bréchot N., Trouillet J.L., Chastre J. Antibiotic stewardship in the intensive care unit. Crit. Care. 2014;18:480. doi: 10.1186/s13054-014-0480-6. - DOI - PMC - PubMed
    1. Barlam T.F., Cosgrove S.E., Abbo L.M., MacDougall C., Schuetz A.N., Septimus E.J., Srinivasan A., Dellit T.H., Falck-Ytter Y.T., Fishman N.O., et al. Implementing an Antibiotic Stewardship Program: Guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America. Clin. Infect. Dis. 2016;62:51–77. doi: 10.1093/cid/ciw118. - DOI - PMC - PubMed
    1. Goff D.A. Antibiotic Stewardship: The Health of the World Depends on It. Hosp. Pharm. 2018;53:214–216. doi: 10.1177/0018578718769964. - DOI - PMC - PubMed

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