scholarly journals Impact of the multidisciplinary antimicrobial stewardship team intervention focusing on carbapenem de‐escalation: A single‐centre and interrupted time series analysis

2020 ◽  
Author(s):  
Ayako Suzuki ◽  
Masayuki Maeda ◽  
Takuya Yokoe ◽  
Miyuki Hashiguchi ◽  
Mayumi Togashi ◽  
...  
Keyword(s):  
Time Series ◽  
Time Series Analysis ◽  
Antimicrobial Stewardship ◽  
Interrupted Time Series ◽  
Interrupted Time Series Analysis ◽  
Single Centre ◽  
Series Analysis

scholarly journals Bibliometric analysis of pharmacist’s research on antimicrobial stewardship in Japan: an interrupted time series analysis on the implementation of the certification system for infection control pharmacists

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Masayuki Maeda ◽  
Takefumi Miyake ◽  
Ryo Inose ◽  
Satoru Ueda ◽  
Ken-ichi Matsugi ◽  
...  
Keyword(s):  
Time Series ◽  
Time Series Analysis ◽  
Infection Control ◽  
Bibliometric Analysis ◽  
Antimicrobial Stewardship ◽  
Interrupted Time Series ◽  
Evidence Based ◽  
Interrupted Time Series Analysis ◽  
Certification System ◽  
Series Analysis

Abstract Background Pharmacist plays an integral role in promoting antimicrobial stewardship (AS) strategies by committing to the evidence-based activities in this field. The present study aims to document trends in actual achievements through bibliometric analysis and identify the future direction of pharmacists with expertise in AS by describing the characteristics of articles on AS written by Japanese pharmacists. Methods The study searched for articles written in Japanese and English on Ichushi-Web and MEDLINE, respectively, until December 2020 for published articles relevant to AS. The articles were classified into the seven groups according to content. Interrupted time series analysis (ITSA) was performed to identify the effect of the certification system for infection control pharmacy specialists (ICPSs) on the number of articles in Japanese. Results The study retrieved 476 and 145 titles from Ichushi-Web and MEDLINE, respectively, out of which 383 and 123 articles written in Japanese and English, respectively, were considered relevant to AS. A continued publication was found for Japanese articles written by pharmacists assigned to large-sized hospitals since 1998, whereas few articles in English were published until 2017. The most frequent content of articles in both languages was intervention (56.7 and 59.0%, respectively). ITSA indicated that the number of publication slightly increased before [β1 = 1.33, 95% confidence interval (CI): − 0.62–3.28; P = 0.169] the implementation of the system. Moreover, the level (β2 = 11.41, 95%CI: − 0.23–23.05; P = 0.054) increased after the implementation of the system, whereas the slope decreased (β3 = − 2.07, 95%CI: − 4.16–0.03; P = 0.053). However, the changes were not statistically significant. Conclusion The study identified the contribution of pharmacists by documenting trends in AS practice and by conducting bibliometric analysis. The implementation of the ICPS certification system positively influenced the trend of publications. Therefore, the study recommends that policymakers and stakeholders should promote and support the evidence-based activities for AS for pharmacists in small- to medium-sized hospitals.

scholarly journals Impact of an Antimicrobial Stewardship Program on the Incidence of Carbapenem Resistant Gram-Negative Bacilli: An Interrupted Time-Series Analysis

Antibiotics ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 586
Author(s):  
Teresa López-Viñau ◽  
Germán Peñalva ◽  
Lucrecia García-Martínez ◽  
Juan José Castón ◽  
Montserrat Muñoz-Rosa ◽  
...  
Keyword(s):  
Time Series ◽  
Time Series Analysis ◽  
Antimicrobial Stewardship ◽  
Interrupted Time Series ◽  
Interrupted Time Series Analysis ◽  
Death Rates ◽  
Gram Negative ◽  
Series Analysis ◽  
Carbapenem Resistant ◽  
The Impact

Carbapenem-resistant Gram-negative bacilli (CR-GNB) are a critical public health threat, and carbapenem use contributes to their spread. Antimicrobial stewardship programs (ASPs) have proven successful in reducing antimicrobial use. However, evidence on the impact of carbapenem resistance remains unclear. We evaluated the impact of a multifaceted ASP on carbapenem use and incidence of CR-GNB in a high-endemic hospital. An interrupted time-series analysis was conducted one year before and two years after starting the ASP to assess carbapenem consumption, CR-GNB incidence, death rates of sentinel events, and other variables potentially related to CR-GNB incidence. An intense reduction in carbapenem consumption occurred after starting the intervention and was sustained two years later (relative effect −83.51%; 95% CI −87.23 to −79.79). The incidence density of CR-GNB decreased by −0.915 cases per 1000 occupied bed days (95% CI −1.743 to −0.087). This effect was especially marked in CR-Klebsiella pneumoniae and CR-Escherichia coli, reversing the pre-intervention upward trend and leading to a relative reduction of −91.15% (95% CI −105.53 to −76.76) and −89.93% (95% CI −107.03 to −72.83), respectively, two years after starting the program. Death rates did not change. This ASP contributed to decreasing CR-GNB incidence through a sustained reduction in antibiotic use without increasing mortality rates.

scholarly journals Antimicrobial stewardship during the COVID-19 epidemic: population-based cohort study and interrupted time series analysis in the United Kingdom

2021 ◽  
pp. BJGP.2020.1051
Author(s):  
Emma Rezel-Potts ◽  
Veline L'Esperance ◽  
Martin Gullifiord
Keyword(s):  
Time Series ◽  
Cohort Study ◽  
Time Series Analysis ◽  
Antimicrobial Stewardship ◽  
Interrupted Time Series ◽  
Population Based ◽  
Antibiotic Prescribing ◽  
Interrupted Time Series Analysis ◽  
Series Analysis ◽  
Tract Infections

Background. The COVID-19 pandemic has altered the context for antimicrobial stewardship in primary care. Aim: To assess the effect of the pandemic on antibiotic prescribing, accounting for changes in consultations for respiratory and urinary tract infections (RTIs/UTIs). Design and Setting: Population-based cohort study using the UK Clinical Practice Research Datalink (CPRD) (January 2017 to September 2020). Method: Interrupted time series analysis evaluated changes in antibiotic prescribing and RTI/UTI consultations adjusting for age, gender, season and secular trends. We assessed the proportion of COVID-19 episodes associated with antibiotic prescribing. Results: There were 253,655 registered patients in 2017 and 232,218 in 2020 with 559,461 antibiotic prescriptions, 216,110 RTI consultations and 36,402 UTI consultations. Compared to pre-pandemic months, March 2020 was associated with higher prescribing (adjusted rate ratio 1.13; 95% confidence interval 1.11 to 1.16). Prescribing fell below predicted rates between April and August 2020, reaching a minimum in May (0.73, 0.71 to 0.75). Pandemic months were associated with lower rates of RTI/UTI consultations, particularly in April for RTIs (0.23; 0.22 to 0.25). There were small reductions in the proportion of RTI consultations with antibiotic prescribed and no reduction for UTIs. Among 25,889 COVID-19 patients, 2,942 (11%) had antibiotics within a COVID-19 episode. Conclusion: Pandemic months were initially associated with increased antibiotic prescribing which then fell below expected levels during the national lockdown. Findings are reassuring that antibiotic stewardship priorities have not been neglected due to COVID-19. Research is required into the effects of reduced RTI/UTI consultations on incidence of serious bacterial infection.

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