Antimicrobial stewardship experiences in acute-care hospitals of Northern Italy: Assessment of structure, process and outcome indicators, 2017-2019. in American journal of infection control / Am J Infect Control. 2023 Mar;51(3):282-288. doi: 10.1016/j.ajic.2022.06.006. Epub 2022 Jun 13.

2023
AOU Alessandria
ASL Alessandria

Tipo pubblicazione

Journal Article

Autori/Collaboratori (5)Vedi tutti...

Zotti CM
Department of Public Health and Paediatrics, University of Turin, Turin, Italy.
Raso R
Regional Epidemiology Service for Infectious Diseases (SeREMI), ASL AL, Alessandria, Italy.
Libero G
Department of Public Health and Paediatrics, University of Turin, Turin, Italy.

et alii...

Abstract

BACKGROUND: Antimicrobial stewardship (AMS) programs are effective strategies for optimizing antimicrobial use. We aimed to assess AMS programs implemented in acute-care trusts of the region of Piedmont, Northern Italy. METHODS: AMS programs were investigated via a survey addressing structure, process and outcome indicators. For outcome indicators, annual means for the years 2017-2019 were considered, as well as the percentage change between 2017 and 2019. Outcome indicators were investigated in relation to structure and process scores using Spearman correlation. RESULTS: In total, 25 AMS programs were surveyed. Higher scores were achieved for process over structure indicators. Improvements in alcohol-based handrub usage (+30%), total antimicrobial usage (-4%), and percentages of methicillin-resistant Staphylococcus aureus and carbapenem-resistant Enterobacteriaceae over invasive isolates (respectively -16 and -23%) were found between 2017 and 2019. Significant correlations were found between structure score and percentage change in total antimicrobial usage and carbapenem-resistant Enterobacteriaceae over invasive isolates (Spearman's ? -0.603, P .006 and ? -0.433, P .044 respectively). DISCUSSION: This study identified areas for improvement: accountability, microbiological laboratory quality management and feedback to clinicians. Improving the organization of AMS programs in particular should be prioritized. CONCLUSION: Repeated measurements of structure and process indicators will be important to guide continuing quality improvement efforts.

Accesso banca dati bibliografica

PMID : 35709971

DOI : 10.1016/j.ajic.2022.06.006

Keywords

Quality indicators; Quality improvement; Italy; Antimicrobial usage; Antimicrobial stewardship; Antimicrobial resistance; Anti-Bacterial Agents/therapeutic use; Hospitals; Italy; Anti-Infective Agents; Humans; Antimicrobial Stewardship; Methicillin-Resistant Staphylococcus aureus;