caa a22 4500 606157743 CHVBK 20210128100615.0 cr unu---uuuuu 210128e20150201xx s 000 0 eng 10.1007/s10096-014-2225-5 doi (NATIONALLICENCE)springer-10.1007/s10096-014-2225-5 The impact of an antimicrobial stewardship programme on the use of antimicrobials and the evolution of drug resistance [Elektronische Daten] [A. del Arco, B. Tortajada, J. de la Torre, J. Olalla, J. Prada, F. Fernández, F. Rivas, J. García-Alegría, V. Faus, N. Montiel] Misuse of antibiotics can provoke increased bacterial resistance. There are no immediate prospects of any new broad-spectrum antibiotics, especially any with activity against enterobacteria, coming onto the market. Therefore, programmes should be implemented to optimise antimicrobial therapy. In a quasi-experimental study, the results for the pre-intervention year were compared with those for the 3years following the application of an antimicrobial stewardship programme. We describe 862 interventions carried out as part of the stewardship programme at the Hospital Costa del Sol from 2009 to 2011. We examined the compliance of the empirical antimicrobial treatment with the programme recommendations and the treatment optimisation achieved by reducing the antibiotic spectrum and adjusting the dose, dosing interval and duration of treatment. In addition, we analysed the evolution of the sensitivity profile of the principal microorganisms and the financial savings achieved. 93% of the treatment recommendations were accepted. The treatment actions taken were to corroborate the empirical treatment (46% in 2009 and 31% in 2011) and to reduce the antimicrobial spectrum taking into account the antibiogram results (37% in 2009 and 58% in 2011). The main drugs assessed were imipenem/meropenem, used in 38.6% of the cases, and cefepime (20.1%). The sensitivity profile of imipenem against Pseudomonas aeruginosa increased by 10% in 2011. Savings in annual drug spending (direct costs) of 30,000 Euros were obtained. Stewardship programmes are useful tools for optimising antimicrobial therapy. They may contribute to preventing increased bacterial resistance and to reducing the long-term financial cost of antibiotic treatment. Springer-Verlag Berlin Heidelberg, 2014 del Arco A. Grupo de Enfermedades Infecciosas, Medicina Interna, Hospital Costa del Sol, Autovía A-7km 189, 29603, Marbella, Málaga, Spain aut Tortajada B. Área de Farmacia y Nutrición, Hospital Costa del Sol, Marbella, Málaga, Spain aut de la Torre J. Grupo de Enfermedades Infecciosas, Medicina Interna, Hospital Costa del Sol, Autovía A-7km 189, 29603, Marbella, Málaga, Spain aut Olalla J. Grupo de Enfermedades Infecciosas, Medicina Interna, Hospital Costa del Sol, Autovía A-7km 189, 29603, Marbella, Málaga, Spain aut Prada J. Grupo de Enfermedades Infecciosas, Medicina Interna, Hospital Costa del Sol, Autovía A-7km 189, 29603, Marbella, Málaga, Spain aut Fernández F. Unidad de Microbiología, Hospital Costa del Sol, Marbella, Málaga, Spain aut Rivas F. Unidad de Apoyo a la Investigación, Hospital Costa del Sol, Marbella, Málaga, Spain aut García-Alegría J. Grupo de Enfermedades Infecciosas, Medicina Interna, Hospital Costa del Sol, Autovía A-7km 189, 29603, Marbella, Málaga, Spain aut Faus V. Área de Farmacia y Nutrición, Hospital Costa del Sol, Marbella, Málaga, Spain aut Montiel N. Unidad de Microbiología, Hospital Costa del Sol, Marbella, Málaga, Spain aut European Journal of Clinical Microbiology & Infectious Diseases Springer Berlin Heidelberg 34/2(2015-02-01), 247-251 0934-9723 34:2<247 2015 34 10096 https://doi.org/10.1007/s10096-014-2225-5 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10096-014-2225-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- del Arco A. Grupo de Enfermedades Infecciosas, Medicina Interna, Hospital Costa del Sol, Autovía A-7km 189, 29603, Marbella, Málaga, Spain aut NATIONALLICENCE 700 1- Tortajada B. Área de Farmacia y Nutrición, Hospital Costa del Sol, Marbella, Málaga, Spain aut NATIONALLICENCE 700 1- de la Torre J. Grupo de Enfermedades Infecciosas, Medicina Interna, Hospital Costa del Sol, Autovía A-7km 189, 29603, Marbella, Málaga, Spain aut NATIONALLICENCE 700 1- Olalla J. Grupo de Enfermedades Infecciosas, Medicina Interna, Hospital Costa del Sol, Autovía A-7km 189, 29603, Marbella, Málaga, Spain aut NATIONALLICENCE 700 1- Prada J. Grupo de Enfermedades Infecciosas, Medicina Interna, Hospital Costa del Sol, Autovía A-7km 189, 29603, Marbella, Málaga, Spain aut NATIONALLICENCE 700 1- Fernández F. Unidad de Microbiología, Hospital Costa del Sol, Marbella, Málaga, Spain aut NATIONALLICENCE 700 1- Rivas F. Unidad de Apoyo a la Investigación, Hospital Costa del Sol, Marbella, Málaga, Spain aut NATIONALLICENCE 700 1- García-Alegría J. Grupo de Enfermedades Infecciosas, Medicina Interna, Hospital Costa del Sol, Autovía A-7km 189, 29603, Marbella, Málaga, Spain aut NATIONALLICENCE 700 1- Faus V. Área de Farmacia y Nutrición, Hospital Costa del Sol, Marbella, Málaga, Spain aut NATIONALLICENCE 700 1- Montiel N. Unidad de Microbiología, Hospital Costa del Sol, Marbella, Málaga, Spain aut NATIONALLICENCE 773 0- European Journal of Clinical Microbiology & Infectious Diseases Springer Berlin Heidelberg 34/2(2015-02-01), 247-251 0934-9723 34:2<247 2015 34 10096