Positive effect of restrictions on antibiotic consumption

Turk J Med Sci. 2018 Apr 30;48(2):361-365. doi: 10.3906/sag-1709-133.

Abstract

Background/aim: This study aimed to examine the change in the etiology of hospital infections with restricting and releasing of group 2 carbapenems (G2C) (meropenem/imipenem/doripenem). Materials and methods: This study was planned in three periods. Study period 1 (SP-1): Carbapenems were prescribed without restriction by infectious disease specialists. SP-2: G2C prescription was restricted. SP-3: Carbapenem prescription was released. Results: In total, 4443 cases [1053 in SP-1 (23.7%), 1332 in SP-2 (29.9%), and 2085 in SP-3 (46.9%)] were included in the study. Infection rates were 11%, 6.5%, and 7.9% in SP-1, SP-2, and SP-3, respectively (P = 0.001). Acinetobacter spp.-related hospital infection rates were 3.9%, 1.2%, and 1.8%, in SP-1, SP-2, and SP-3, respectively (P = 0.0001). Infection related mortality in SP-1, SP-2, and SP-3 was 7.3%, 5%, and 3.8%, respectively (P = 0.001). Conclusion: Hospital-acquired Acinetobacter infections, antibiotic consumption, and infection-related mortality were decreased significantly with the restriction of G2C. Positive behaviors that were obtained during the restricted period were continued with release of restriction.

Keywords: Restriction of carbapenem; antibiotic stewardships; hospital-acquired Acinetobacter infections; infection related mortality.