Universität zu Köln

Hohn, A., Heising, B., Hertel, S., Baumgarten, G., Hochreiter, M. and Schroeder, S. (2015). Antibiotic consumption after implementation of a procalcitonin-guided antimicrobial stewardship programme in surgical patients admitted to an intensive care unit: a retrospective before-and-after analysis. Infection, 43 (4). S. 405 - 413. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1439-0973

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Abstract

Purpose To analyse antibiotic use density (AD)-World Health Organization defined daily doses/1,000 patient-days-before and after implementation of a local antimicrobial stewardship programme (ASP) in conjunction with a procalcitonin (PCT)-guided protocol in a surgical intensive care unit (ICU). Methods In this retrospective observational study, data on 2,422 ICU patients between 2010 and 2012 were analysed. In 2011, an ASP in conjunction with a PCT protocol had been introduced into clinical practice. In a multivariate analysis, hospital mortality, length of stay (LOS) in hospital and ICU LOS were adjusted for effects from effective cost weight, gender, and age. AD and changes in the use of antibiotic classes were analysed. Results AD decreased from 1,005.0 in 2010 to 791.9 in 2012 which is a total reduction of 21.2 %. Consumption of aminoglycosides, cephalosporins and quinolones showed a marked reduction, whereas the use of penicillins did not change significantly. The multivariate models revealed no relevant changes in mortality rate, ICU LOS and hospital LOS. Conclusions Implementation of an ASP in conjunction with a PCT protocol in 2011 was associated with a marked decrease in total AD and led to a significant change in the spectrum of antibiotics. Clinical outcomes appeared to remain unchanged over the study period.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Hohn, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Heising, B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hertel, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Baumgarten, G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hochreiter, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schroeder, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-397102
DOI:	10.1007/s15010-014-0718-x
Journal or Publication Title:	Infection
Volume:	43
Number:	4
Page Range:	S. 405 - 413
Date:	2015
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1439-0973
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CLOSTRIDIUM-DIFFICILE; RESISTANCE; THERAPY; IMPACT; SUSCEPTIBILITY; METAANALYSIS; ALGORITHMS; EMERGENCE Multiple languages Infectious Diseases Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/39710