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Observational Study
. 2022 May 2;22(1):420.
doi: 10.1186/s12879-022-07410-6.

Impact of antimicrobial stewardship programs on antibiotic consumption and antimicrobial resistance in four Colombian healthcare institutions

Christian Pallares  1   2   3 , Cristhian Hernández-Gómez  4   5 , Tobías Manuel Appel  4 , Kevin Escandón  5   6 , Sergio Reyes  5 , Soraya Salcedo  7 , Lorena Matta  8 , Ernesto Martínez  9 , Sara Cobo  10 , Laura Mora  7 , Adriana Marín  7 , Adriana Correa  5   11 , Elsa De La Cadena  4   5 , Jesús Rodríguez-Baño  12   13 , María Virginia Villegas  4   5   14
Affiliations
Observational Study

Impact of antimicrobial stewardship programs on antibiotic consumption and antimicrobial resistance in four Colombian healthcare institutions

Christian Pallares et al. BMC Infect Dis. .

Abstract

Background: Antimicrobial stewardship programs (ASPs) have become a fundamental pillar in optimizing antimicrobial usage, improving patient care, and reducing antimicrobial resistance (AMR). Herein we evaluated the impact of an ASP on antimicrobial consumption and AMR in Colombia.

Methods: We designed a retrospective observational study and measured trends in antibiotic consumption and AMR before and after the implementation of an ASP using interrupted time series analysis over a 4-year period (24 months before and 24 months after ASP implementation).

Results: ASPs were implemented according to the available resources in each of the institutions. Before ASP implementation, there was a trend toward an increase in the antibiotic consumption of all measured antimicrobials selected. Afterward, an overall decrease in antibiotic consumption was observed. The use of ertapenem and meropenem decreased in hospital wards, while a decrease in the use of ceftriaxone, cefepime, piperacillin/tazobactam, meropenem, and vancomycin was observed in intensive care units. After ASP implementation, the trend toward an increase of oxacillin-resistant Staphylococcus aureus, ceftriaxone-resistant Escherichia coli, and meropenem-resistant Pseudomonas aeruginosa was reversed.

Conclusions: In our study, we showed that ASPs are a key strategy in tackling the emerging threat of AMR and have a positive impact on antibiotic consumption and resistance.

Keywords: Antibiotic resistance; Antimicrobial resistance; Antimicrobial stewardship; Antimicrobial stewardship program; Colombia; Hospital epidemiology.

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Conflict of interest statement

KE, who is a Senior Editorial Board Member for BMC Infectious Diseases, was not involved in the peer-review of the manuscript or its acceptance. Two editors for the BMC Series and two expert reviewers assessed this manuscript. EM, CP, and CHG have received fees for consultancy and scientific conferences or research support from Merck Sharp & Dohme and Pfizer. MVV has received consulting fees and research grants from Merck Sharp & Dohme, Pfizer, Janssen-Cilag, Novartis, Merck, West, OpGen, and AstraZeneca. The other authors declare no conflicts of interest for this article.

Figures

Fig. 1
Fig. 1
Trend of DDD per 100 occupied bed-days) for consumption of broad-spectrum antibiotics (ceftriaxone, cefepime, piperacillin/tazobactam, ertapenem, meropenem, and vancomycin) in ICUs and general wards
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