title: Evaluation of the short-term effects of antimicrobial stewardship in the intensive care unit at a tertiary hospital in China.
abstract: Antibiotic abuse can lead to antibiotic resistance, which is a severe problem in China. The purpose of this study is to evaluate the short-term effects of antimicrobial stewardship strategies, including formulary restriction, preauthorization, perioperative quinolone restriction, and control of total antibiotic consumption in the ICU at a tertiary hospital in China. After implementation of antimicrobial stewardship, the total antibiotic consumption in the ICU significantly decreased. The defined daily doses (DDDs) per 100 patient-days decreased from 197.65 to 143.41; however, the consumption of cephalosporins increased from 53.65 to 63.17 DDDs. Significant improvements in resistance to amikacin, gentamicin, ciprofloxacin, ofloxacin, ceftriaxone, ceftazidime, and piperacillin in Enterobacteriaceae and resistance to ceftazidime, imipenem, and meropenem in non-fermenting Gram-negative rods were observed. In addition, the initial use of no antibiotics or of a single antibiotic significantly increased (P<0.001) and the use of two antibiotics in combination significantly decreased (P<0.001). Our results demonstrate that implementation of antimicrobial stewardship in a short period in the ICU dramatically reduced antibiotic consumption and significantly improved antibiotic resistance, which leads to more reasonable antibiotic selections by ICU physicians.
authors.affiliation: Department of Intensive Care Unit, the Affiliated Hospital of Taishan Medical College, Taian, Shandong, China.
authors.forename: Dapeng
authors.initials: D
authors.lastname: Hou
authors.affiliation: Department of Intensive Care Unit, the Affiliated Hospital of Taishan Medical College, Taian, Shandong, China.
authors.forename: Qiushi
authors.initials: Q
authors.lastname: Wang
authors.affiliation: Department of Intensive Care Unit, the Affiliated Hospital of Taishan Medical College, Taian, Shandong, China.
authors.forename: Cuihua
authors.initials: C
authors.lastname: Jiang
authors.affiliation: Department of Intensive Care Unit, the Affiliated Hospital of Taishan Medical College, Taian, Shandong, China.
authors.forename: Cui
authors.initials: C
authors.lastname: Tian
authors.affiliation: Department of Intensive Care Unit, the Affiliated Hospital of Taishan Medical College, Taian, Shandong, China.
authors.forename: Huaqing
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Thoracic Surgery, the Affiliated Hospital of Taishan Medical College, Taian, Shandong, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Ji
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002681:China; D005260:Female; D006801:Humans; D057970:Inappropriate Prescribing / Q000517:prevention & control* / Q000706:statistics & numerical data*; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D062606:Tertiary Care Centers / Q000706:statistics & numerical data*; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents