Evaluation Of The Short-term Effects Of Antimicrobial Stewardship In The Intensive Care Unit At A Tertiary Hospital

Objective:The purpose of this study was to evaluate the short-term effects of the antimicrobial stewardship strategies implemented in the ICU at a tertiary hospital.Methods:The antimicrobial stewardship consisted of formulary restriction, preauthorization, peroperative quinolone restriction and control of total antibiotic consumption.Results:As a result of the implementation of antimicrobial stewardship, the total antibiotic consumption in the ICU decreased significantly, with the DDDs per 100 patient-days decreasing from 197.65 to 143.41. In addition, the cumulative consumption decreased significantly in terms of the use of quinolones, imidazoles and other beta-lactams, macrolides and especially quinolones. Enterobacteriaceae displayed obvious decreases in resistance to amikacin, gentamicin, ciprofloxacin, ofloxacin, ceftriaxone, ceftazidime and piperacillin. Non-fermenting gram-negative rods displayed obvious decreases in resistance to ceftazidime, imipenem and meropenem. Concomitantly, the consumption of cephalosporins increased from 53.65 to 63.17 DDDs. In addition, after implementation of antimicrobial stewardship, the initial use of no antibiotic or a single antibiotic displayed a significant proportional increase(5.0% vs 2.3% and 78.9% vs 20.5%, respectively), and combination therapy of two antibiotics was significantly decreased(16.1% vs 74.1%). After the implementation, in the non-infectious disease group, there was a higher proportion in the initial use of no antibiotic or single antibiotic(5.5% vs 2.3% and 81.3% vs 65.9%, respectively), whereas the use of two antibiotics was lower(13.2% vs 31.8%).Conclusion:The reported data suggest that through antimicrobial stewardship, within a relatively short period, antibiotic consumption decreased, meanwhile, the antibiotic resistance improved obviously, and ICU physician antibiotic selection could be more reasonable.