Prospective monitoring of carbapenem use and pseudomonal resistance across pediatric institutions

Isao Miyairi, Kensuke Shoji, Noriko Kinoshita, Junpei Saitoh, Yoshie Sugahara, Yasushi Watanabe, Makoto Komura, Masashi Kasai, Yuho Horikoshi, Masayoshi Shinjoh, Takashi Igarashi

研究成果: Article査読

4 被引用数 (Scopus)

抄録

Objective: To determine whether carbapenem consumption and Pseudomonas aeruginosa resistance rates can be used as benchmarks to compare and improve antimicrobial stewardship programs across multiple pediatric hospitals.Design: A prospective study.Setting and participants: Healthcare institutions in Japan with >100 pediatric beds.Methods: An annual survey of the total days of therapy (DOT) per 1,000 patient days for carbapenem antibiotics (meropenem, imipenem-cilastatin, panipenem-betamipron, doripenem) and susceptibility rates of Pseudomonas aeruginosa to meropenem and imipenem-cilastatin from each institution was conducted over a 7-year period. Data were reported to the administration, as well as to the infection control team, of each institution annually.Results: Data were obtained from 32 facilities. The median total carbapenem DOT per 1,000 patient days was 16.6 and varied widely, with a range of 2.7 to 59.0. The median susceptibility to meropenem was 86.6%, ranging from 78.6% to 96.6%. We detected an inverse correlation between total carbapenem DOT versus susceptibility (r =-0.36; P <.01). Over the 7-year period, the DOT per 1,000 patient days of carbapenem decreased by 27% from a median of 16.0 to 11.7 (P <.01). We also observed an improvement in susceptibility to meropenem from a median of 87% to 89.7% (P =.01) and to imipenem-cilastatin from 79% to 85% (P <.01). The decreases in the use of carbapenem were greater in institutions with antimicrobial stewardship programs led by pediatric infectious disease specialists.Conclusions: Antimicrobial use and resistance, targeting carbapenems and P. aeruginosa, respectively, can serve as benchmarks that can be utilized to promote antimicrobial stewardship across pediatric healthcare institutions.

本文言語English
ページ(範囲)1042-1047
ページ数6
ジャーナルInfection Control and Hospital Epidemiology
41
9
DOI
出版ステータスPublished - 2020 9月 1

ASJC Scopus subject areas

  • 疫学
  • 微生物学(医療)
  • 感染症

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