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KMID : 1812620230030020171
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HIRA Research
2023 Volume.3 No. 2 p.171 ~ p.181
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Effectiveness of Antibiotic Usage Intervention through the Implementation of Prospective Audit and Feedback in the Intensive Care Units of a Single Tertiary Care Hospital
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Yoon Jin-Gu
Choi Ha-Neul
Kim Sung-Ran
Cho Min-Hee
Choi Yu-Jung
Nham Eliel
Seong Hye
Noh Ji-Yun
Cheong Hee-Jin
Kim Woo-Joo
Song Joon-Young
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Abstract
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Background: The implementation of antibiotic stewardship program (ASP) has been encouraged in developed countries in response to increasing antibiotic resistance. However, the implementation of ASP has been limited owing to a lack of manpower and awareness. We aimed to analyze the effectiveness of prospective audit and feedback (PAF), one of the core strategies in ASP, by applying it to the intensive care units (ICUs).
Methods: In this study, we applied PAF to the neurological/surgical ICUs of a tertiary hospital starting from March 1, 2023, we compared the data of 6 months before (from September 2022 to February 2023) and after (from March 2023 to August 2023) the implementation to assess the difference in antimicrobial use density (AUD) and the acquisition rates of antibiotic-resistant bacteria. Furthermore, we surveyed the satisfaction of PAF using a questionnaire. PAF was conducted twice a week during rounds by the ASP team, which consisted of an infectious disease specialist and one assistant.
Results: Before and after the implementation of PAF, AUD showed a tendency to decrease in the classes of beta-lactam/beta-lactamase inhibitors, cephalosporins and glycopeptides, although the changes were not statistically significant. The acquisition rate of carbapenem-resistant Acinetobacter baumannii decreased slightly in the surgical ICU. Most participating interns and residents reported that PAF was clinically and educationally helpful in the survey.
Conclusion: Implementing PAF twice a week in the neurological/surgical ICUs could reduce antibiotic usage and the acquisition rates of some resistant bacteria.
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KEYWORD
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Antimicrobial stewardship, Drug resistance, microbial, Intensive care units
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