title: Impact of a clinical microbiology-intensive care consulting program in a cardiothoracic intensive care unit.
abstract: A preintervention-postintervention study was carried out over a 4-year period to assess the impact of an antimicrobial stewardship intervention, based on clinical microbiologist ward rounds (clinical microbiology-intensive care partnership [CMICP]), at a cardiothoracic intensive care unit. Comparison of clinical data for 37 patients with diagnosis of bacteremia (18 from preintervention period, 19 from postintervention period) revealed that CMICP implementation resulted in (1) significant increase of appropriate empirical treatments (+34%, P = .029), compliance with guidelines (+28%, P = .019), and number of de-escalations (+42%, P = .032); and (2) decrease (average = 2.5 days) in time to optimization of antimicrobial therapy and levofloxacin (Δ 2009-2012 = -74 defined daily dose [DDD]/1,000 bed days) and teicoplanin (Δ 2009-2012 = -28 DDD/1,000 bed days) use.
authors.affiliation: Department of Medical Biotechnologies, University of Siena, Siena, Italy. Electronic address: arena2@unisi.it.
authors.forename: Fabio
authors.initials: F
authors.lastname: Arena
authors.affiliation: Department of Medical Biotechnologies, University of Siena, Siena, Italy; Cardiothoracic Anesthesia and Intensive Care Unit, Siena University Hospital, Siena, Italy.
authors.forename: Sabino
authors.initials: S
authors.lastname: Scolletta
authors.affiliation: Cardiothoracic Anesthesia and Intensive Care Unit, Siena University Hospital, Siena, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Marchetti
authors.affiliation: Department of Medical Biotechnologies, University of Siena, Siena, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Galano
authors.affiliation: Cardiothoracic Anesthesia and Intensive Care Unit, Siena University Hospital, Siena, Italy.
authors.forename: Enivarco
authors.initials: E
authors.lastname: Maglioni
authors.affiliation: Department of Medical Biotechnologies, University of Siena, Siena, Italy.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Giani
authors.affiliation: Microbiology and Virology Unit, Siena University Hospital, Siena, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Corsi
authors.affiliation: Department of Medical Biotechnologies, University of Siena, Siena, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Lombardi
authors.affiliation: Department of Medical Biotechnologies, University of Siena, Siena, Italy; Cardiothoracic Anesthesia and Intensive Care Unit, Siena University Hospital, Siena, Italy.
authors.forename: Bonizella
authors.initials: B
authors.lastname: Biagioli
authors.affiliation: Department of Medical Biotechnologies, University of Siena, Siena, Italy; Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Clinical Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy.
authors.forename: Gian Maria
authors.initials: GM
authors.lastname: Rossolini
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D000073602:Antimicrobial Stewardship; D016470:Bacteremia / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008829:Microbiology; D008875:Middle Aged; D012017:Referral and Consultation; D016896:Treatment Outcome
chemical_list: D000890:Anti-Infective Agents
keywords: Antibiotic consumption; Antimicrobial stewardship; Clinical microbiologist; Consultant; Intensive care unit; Sepsis