A simple and feasible antimicrobial stewardship program in a neonatal intensive care unit of a Japanese community hospital

Although tertiary hospitals have successfully introduced ASPs by antimicrobial stewardship teams, lots of community hospitals without pediatric infectious disease specialists have difficulty implementing ASP. We present a successful implementation of simple and feasible NICU antimicrobial stewardshi...

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Bibliographic Details
Published in:Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 2019-11, Vol.25 (11), p.860-865
Main Authors: Kitano, Taito, Takagi, Kumiko, Arai, Ikuyo, Yasuhara, Hajime, Ebisu, Reiko, Ohgitani, Ayako, Kitagawa, Daisuke, Oka, Miyako, Masuo, Kazue, Minowa, Hideki
Format: Article
Language:English
Subjects:
Anti-Bacterial Agents - therapeutic use
Antimicrobial stewardship
Antimicrobial Stewardship - methods
Communicable Diseases - drug therapy
Guideline Adherence
Hospitals, Community - methods
Humans
Intensive Care Units, Neonatal
Japan
Methicillin-Resistant Staphylococcus aureus - drug effects
Neonatal intensive care unit
Neonatal sepsis
Protocol
Quality improvement
Retrospective Studies
Staphylococcal Infections - drug therapy
Tertiary Care Centers
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Summary:Although tertiary hospitals have successfully introduced ASPs by antimicrobial stewardship teams, lots of community hospitals without pediatric infectious disease specialists have difficulty implementing ASP. We present a successful implementation of simple and feasible NICU antimicrobial stewardship program in a Japanese community hospital. We developed a protocol of antimicrobial treatment in our NICU department and have implemented the protocol from September 2017. The protocol consists of start and stop of criteria antimicrobial treatment, weekend report of blood culture result from microbiology department and stopping ordering antimicrobials beforehand for the next day. We compared days of therapy (DOT) during the post-implementation period (September 2017 to August 2018) with that of pre-implementation period (March 2013 to August 2017). In pre- and post-ASP implementation periods, 913 and 194 patients were analyzed. DOT was 175.1 and 41.6/1000 patient-days, respectively (p 
ISSN:1341-321X
1437-7780
DOI:10.1016/j.jiac.2019.04.012