Session Type: 1-hour Mini Oral Flash
Session Title: 1-hour Mini Oral Flash
Authors(s): P. Favier (1), L. Scocozza (2), S. Cogut (2), L. Guelfand (2), M. Gismondi (3), M. Jaume (3), M. Cabrini (3), N. D´amico (3), M. Flor (3), J. Baselca (3), L. Pérez (3), L. Rodríguez (3), G. Levy Hara (1), W. Vasen (1), P. Scapellato (1), A. Sisto (3), M. Rolón (3)
Authors Affiliations(s): (1) Antimicrobial Stewardship Program. Health Ministry Of Buenos Aires City, Argentina, (2) Dr. Juan A. Fernández Hospital, Microbiology Area, Argentina, (3) Dr. Juan A. Fernández Hospital, Infectious Diseases Area, Argentina
Background:
Despite Clostridioides difficile infection (CDI) attributed to high ecological impact drugs overuse is a health priority; the current COVID-19 pandemic has led us to relegate this concept. Moreover, antibiotics have been used empirically in hospitalized COVID-19 patients (pCOVID) due to the overlapping clinical and radiological features with bacterial respiratory tract infections. This study was aimed to determine the impact of an antimicrobial stewardship bundle (ASB) targeting broad-spectrum cephalosporin (BSC), fluoroquinolones and clindamycin use in hospitalized pCOVID. The secondary goal was to measure the incidence of CDI in these patients after this strategy.
Methods:Quasi-experimental model was addressed to evaluate the effect of the intervention using interrumpted time-series (ITS) between 21st-22nd 2020 epidemiological weeks (P1: preintervention) and 23rd-45th ones (P2: intervention). The setting was the adult wards of a university hospital in Buenos Aires, Argentina. Weekly antibiotic use data, expressed as day of treatment (DOT)/ 100 pCOVID, were used for the analysis. CDI was defined as IDSA/SHEA 2017 guidelines established by a multistep algorithm. CDI incidence was informed as CDI/10000 pCOVID-day. The ASB included: local guidelines, peer-to-peer education, intensified ID consultations and virtual sessions. Statistics analysis were performed by R-Statistics 4.0.3TM by considering significant a p value <0.05.
Results:4088 antibiotic DOT prescribed to 1956 pCOVID were analyzed. During P2, ITS confirmed a highly significant intervention change in BSC consumption level with a reduction and dropped by −20% [-37% -2.3%] p<0.03. Similar effect was observed, as a tendency, in carbapenems prescriptions, (−2.4% [-5.1% -2.4%] p<0.07). Fluoroquinolones (3.3 DOT/100pCOVID in P2, p=0.2) and clindamycin (0.3 DOT/100pCOVID in P2, p=0.5) use levels were stably low, unlike aminopenicillin/β-lactamase-inhibitor formulations (+12.8% [+5.6% +19.9%] p<0.03) and piperacillin-tazobactam (+5.9% [+1.3% +10.5%] p<0.01) that reached a significant increment. Overall CDI rate was 3.9 cases/10000 pCOVID-day.
Conclusions:Our multi-targeting anti-Clostridioides difficile ASB was an effective tool to reduce BSC and carbapenems use and to remain the fluoroquinolones and clindamycin consumption low. Even more, one of the goals of our ASB was to encourage the administration of less environmental-impact drugs. Finally, this strategy succeeded in establishing a CDI incidence similar to that reported in pCOVID but in high-income countries.
Keyword(s): Clostridioides difficile, Antimicrobial Stewardship, COVID-19Session Type: 1-hour Mini Oral Flash
Session Title: 1-hour Mini Oral Flash
Authors(s): P. Favier (1), L. Scocozza (2), S. Cogut (2), L. Guelfand (2), M. Gismondi (3), M. Jaume (3), M. Cabrini (3), N. D´amico (3), M. Flor (3), J. Baselca (3), L. Pérez (3), L. Rodríguez (3), G. Levy Hara (1), W. Vasen (1), P. Scapellato (1), A. Sisto (3), M. Rolón (3)
Authors Affiliations(s): (1) Antimicrobial Stewardship Program. Health Ministry Of Buenos Aires City, Argentina, (2) Dr. Juan A. Fernández Hospital, Microbiology Area, Argentina, (3) Dr. Juan A. Fernández Hospital, Infectious Diseases Area, Argentina
Background:
Despite Clostridioides difficile infection (CDI) attributed to high ecological impact drugs overuse is a health priority; the current COVID-19 pandemic has led us to relegate this concept. Moreover, antibiotics have been used empirically in hospitalized COVID-19 patients (pCOVID) due to the overlapping clinical and radiological features with bacterial respiratory tract infections. This study was aimed to determine the impact of an antimicrobial stewardship bundle (ASB) targeting broad-spectrum cephalosporin (BSC), fluoroquinolones and clindamycin use in hospitalized pCOVID. The secondary goal was to measure the incidence of CDI in these patients after this strategy.
Methods:Quasi-experimental model was addressed to evaluate the effect of the intervention using interrumpted time-series (ITS) between 21st-22nd 2020 epidemiological weeks (P1: preintervention) and 23rd-45th ones (P2: intervention). The setting was the adult wards of a university hospital in Buenos Aires, Argentina. Weekly antibiotic use data, expressed as day of treatment (DOT)/ 100 pCOVID, were used for the analysis. CDI was defined as IDSA/SHEA 2017 guidelines established by a multistep algorithm. CDI incidence was informed as CDI/10000 pCOVID-day. The ASB included: local guidelines, peer-to-peer education, intensified ID consultations and virtual sessions. Statistics analysis were performed by R-Statistics 4.0.3TM by considering significant a p value <0.05.
Results:4088 antibiotic DOT prescribed to 1956 pCOVID were analyzed. During P2, ITS confirmed a highly significant intervention change in BSC consumption level with a reduction and dropped by −20% [-37% -2.3%] p<0.03. Similar effect was observed, as a tendency, in carbapenems prescriptions, (−2.4% [-5.1% -2.4%] p<0.07). Fluoroquinolones (3.3 DOT/100pCOVID in P2, p=0.2) and clindamycin (0.3 DOT/100pCOVID in P2, p=0.5) use levels were stably low, unlike aminopenicillin/β-lactamase-inhibitor formulations (+12.8% [+5.6% +19.9%] p<0.03) and piperacillin-tazobactam (+5.9% [+1.3% +10.5%] p<0.01) that reached a significant increment. Overall CDI rate was 3.9 cases/10000 pCOVID-day.
Conclusions:Our multi-targeting anti-Clostridioides difficile ASB was an effective tool to reduce BSC and carbapenems use and to remain the fluoroquinolones and clindamycin consumption low. Even more, one of the goals of our ASB was to encourage the administration of less environmental-impact drugs. Finally, this strategy succeeded in establishing a CDI incidence similar to that reported in pCOVID but in high-income countries.
Keyword(s): Clostridioides difficile, Antimicrobial Stewardship, COVID-19
Session Type: 1-hour Mini Oral Flash
Session Title: 1-hour Mini Oral Flash
Authors(s): P. Favier (1), L. Scocozza (2), S. Cogut (2), L. Guelfand (2), M. Gismondi (3), M. Jaume (3), M. Cabrini (3), N. D´amico (3), M. Flor (3), J. Baselca (3), L. Pérez (3), L. Rodríguez (3), G. Levy Hara (1), W. Vasen (1), P. Scapellato (1), A. Sisto (3), M. Rolón (3)
Authors Affiliations(s): (1) Antimicrobial Stewardship Program. Health Ministry Of Buenos Aires City, Argentina, (2) Dr. Juan A. Fernández Hospital, Microbiology Area, Argentina, (3) Dr. Juan A. Fernández Hospital, Infectious Diseases Area, Argentina
Background:
Despite Clostridioides difficile infection (CDI) attributed to high ecological impact drugs overuse is a health priority; the current COVID-19 pandemic has led us to relegate this concept. Moreover, antibiotics have been used empirically in hospitalized COVID-19 patients (pCOVID) due to the overlapping clinical and radiological features with bacterial respiratory tract infections. This study was aimed to determine the impact of an antimicrobial stewardship bundle (ASB) targeting broad-spectrum cephalosporin (BSC), fluoroquinolones and clindamycin use in hospitalized pCOVID. The secondary goal was to measure the incidence of CDI in these patients after this strategy.
Methods:Quasi-experimental model was addressed to evaluate the effect of the intervention using interrumpted time-series (ITS) between 21st-22nd 2020 epidemiological weeks (P1: preintervention) and 23rd-45th ones (P2: intervention). The setting was the adult wards of a university hospital in Buenos Aires, Argentina. Weekly antibiotic use data, expressed as day of treatment (DOT)/ 100 pCOVID, were used for the analysis. CDI was defined as IDSA/SHEA 2017 guidelines established by a multistep algorithm. CDI incidence was informed as CDI/10000 pCOVID-day. The ASB included: local guidelines, peer-to-peer education, intensified ID consultations and virtual sessions. Statistics analysis were performed by R-Statistics 4.0.3TM by considering significant a p value <0.05.
Results:4088 antibiotic DOT prescribed to 1956 pCOVID were analyzed. During P2, ITS confirmed a highly significant intervention change in BSC consumption level with a reduction and dropped by −20% [-37% -2.3%] p<0.03. Similar effect was observed, as a tendency, in carbapenems prescriptions, (−2.4% [-5.1% -2.4%] p<0.07). Fluoroquinolones (3.3 DOT/100pCOVID in P2, p=0.2) and clindamycin (0.3 DOT/100pCOVID in P2, p=0.5) use levels were stably low, unlike aminopenicillin/β-lactamase-inhibitor formulations (+12.8% [+5.6% +19.9%] p<0.03) and piperacillin-tazobactam (+5.9% [+1.3% +10.5%] p<0.01) that reached a significant increment. Overall CDI rate was 3.9 cases/10000 pCOVID-day.
Conclusions:Our multi-targeting anti-Clostridioides difficile ASB was an effective tool to reduce BSC and carbapenems use and to remain the fluoroquinolones and clindamycin consumption low. Even more, one of the goals of our ASB was to encourage the administration of less environmental-impact drugs. Finally, this strategy succeeded in establishing a CDI incidence similar to that reported in pCOVID but in high-income countries.
Keyword(s): Clostridioides difficile, Antimicrobial Stewardship, COVID-19Session Type: 1-hour Mini Oral Flash
Session Title: 1-hour Mini Oral Flash
Authors(s): P. Favier (1), L. Scocozza (2), S. Cogut (2), L. Guelfand (2), M. Gismondi (3), M. Jaume (3), M. Cabrini (3), N. D´amico (3), M. Flor (3), J. Baselca (3), L. Pérez (3), L. Rodríguez (3), G. Levy Hara (1), W. Vasen (1), P. Scapellato (1), A. Sisto (3), M. Rolón (3)
Authors Affiliations(s): (1) Antimicrobial Stewardship Program. Health Ministry Of Buenos Aires City, Argentina, (2) Dr. Juan A. Fernández Hospital, Microbiology Area, Argentina, (3) Dr. Juan A. Fernández Hospital, Infectious Diseases Area, Argentina
Background:
Despite Clostridioides difficile infection (CDI) attributed to high ecological impact drugs overuse is a health priority; the current COVID-19 pandemic has led us to relegate this concept. Moreover, antibiotics have been used empirically in hospitalized COVID-19 patients (pCOVID) due to the overlapping clinical and radiological features with bacterial respiratory tract infections. This study was aimed to determine the impact of an antimicrobial stewardship bundle (ASB) targeting broad-spectrum cephalosporin (BSC), fluoroquinolones and clindamycin use in hospitalized pCOVID. The secondary goal was to measure the incidence of CDI in these patients after this strategy.
Methods:Quasi-experimental model was addressed to evaluate the effect of the intervention using interrumpted time-series (ITS) between 21st-22nd 2020 epidemiological weeks (P1: preintervention) and 23rd-45th ones (P2: intervention). The setting was the adult wards of a university hospital in Buenos Aires, Argentina. Weekly antibiotic use data, expressed as day of treatment (DOT)/ 100 pCOVID, were used for the analysis. CDI was defined as IDSA/SHEA 2017 guidelines established by a multistep algorithm. CDI incidence was informed as CDI/10000 pCOVID-day. The ASB included: local guidelines, peer-to-peer education, intensified ID consultations and virtual sessions. Statistics analysis were performed by R-Statistics 4.0.3TM by considering significant a p value <0.05.
Results:4088 antibiotic DOT prescribed to 1956 pCOVID were analyzed. During P2, ITS confirmed a highly significant intervention change in BSC consumption level with a reduction and dropped by −20% [-37% -2.3%] p<0.03. Similar effect was observed, as a tendency, in carbapenems prescriptions, (−2.4% [-5.1% -2.4%] p<0.07). Fluoroquinolones (3.3 DOT/100pCOVID in P2, p=0.2) and clindamycin (0.3 DOT/100pCOVID in P2, p=0.5) use levels were stably low, unlike aminopenicillin/β-lactamase-inhibitor formulations (+12.8% [+5.6% +19.9%] p<0.03) and piperacillin-tazobactam (+5.9% [+1.3% +10.5%] p<0.01) that reached a significant increment. Overall CDI rate was 3.9 cases/10000 pCOVID-day.
Conclusions:Our multi-targeting anti-Clostridioides difficile ASB was an effective tool to reduce BSC and carbapenems use and to remain the fluoroquinolones and clindamycin consumption low. Even more, one of the goals of our ASB was to encourage the administration of less environmental-impact drugs. Finally, this strategy succeeded in establishing a CDI incidence similar to that reported in pCOVID but in high-income countries.
Keyword(s): Clostridioides difficile, Antimicrobial Stewardship, COVID-19