Does a reduction in antibiotic consumption always represent a favorable outcome from an intervention program on prescribing practice?

January 10, 2017 at 8:50 am

Int J Infect Dis. 2006 May;10(3):231-5. Epub 2006 Feb 9.

Bantar C1, Franco D, Heft C, Vesco E, Arango C, Izaguirre M, Oliva ME.

Author information

1Services of Infection Control, Hospital San Martín, Paraná, Entre Ríos, Argentina. cbantar@arnet.com.ar

Abstract

OBJECTIVES:

In our hospital, a continuous intervention program aimed at optimizing the quality of antibiotic use was introduced by late 1999 and antibiotic consumption was a major outcome for assessment.

However, healthcare conditions have been subject to change over the last five years, and a pronounced economic crisis in 2002 affected the availability of antibiotics.

Therefore, we hypothesized that the consumption of these drugs could be a suitable indirect marker of the crisis.

DESIGN:

We performed segmented regression analysis between different periods. Variations in antibiotic consumption during periods corresponding to the four-phase intervention program (from 1999 to the first six months of 2001) were assumed to be ‘intervention-induced’, while those observed during the crisis period were considered as ‘situation-enforced’.

RESULTS:

Whereas the intervention-induced (desirable) decrease of total antibiotic and carbapenem consumption proved to correlate with a decreased crude mortality rate during the control period prior to the crisis (R2, 0.82 and 0.91, respectively), the crisis-induced (undesirable) decrease in total antibiotic and carbapenem consumption correlated with an increased mortality during this phase (R2, 0.80 and 0.75, respectively).

CONCLUSIONS:

Our results illustrate that a reduction in antibiotic consumption does not always represent a favorable outcome from an intervention program on prescribing practice. Moreover, it may be a sensitive indirect marker of a deficient healthcare condition leading to an increase in in-hospital mortality.

PDF

http://www.ijidonline.com/article/S1201-9712(06)00004-X/pdf

Entry filed under: Antimicrobianos, Bacterias, Bacteriemias, Health Care-Associated Infections, Infecciones nosocomiales, Metodos diagnosticos, REPORTS, Resistencia bacteriana, Update. Tags: .

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