Work

Effectiveness of an antimicrobial stewardship program using an automated antimicrobial surveillance system based on indication for antimicrobial administration

Year: 2025

Type: article

Abstract: BACKGROUND: Conventional antimicrobial surveillance measures usage in days of therapy (DOT). However, assessments using DOT alone often ignore indication-specific details, which limits the identification of targets for antimicrobial stewardship (AS) interventions. Therefore, we have developed an automated surveillance system (the Antimicrobial and Patient Background Surveillance System [APBSS]) in order to analyze antimicrobial use based on indications, and evaluated the short-term effectiveness of an AS program using APBSS surveillance data, as an initial evaluation of the newly developed system. METHODS: Using an interrupted time series design, we calculated the carbapenem DOT per 100 patient days as the primary outcome by comparing the pre-intervention (October 2022 to September 2024) and post-intervention (October 2024 to September 2025) periods. During the intervention, the AS team presented the APBSS surveillance data, including indication-specific antimicrobial use, patient characteristics, annual trends at our hospital, and multicenter comparisons. The antipseudomonal agent DOT was a secondary outcome. RESULTS: Patient characteristics did not differ substantially between the periods. APBSS surveillance data identified key issues, including high carbapenem use in specific infections (e.g. Gram-negative rod bacteremia), which occurred despite the lower proportion of patients with hematological malignancies compared with other hospitals. However, the intervention significantly reduced carbapenem DOT levels (level change: −0.69/100 patient days, p = 0.017). The antipseudomonal agent DOT also significantly decreased (level change: −1.7/100 patient days, p = 0.004). CONCLUSIONS: The AS program that used APBSS surveillance data improved the use of carbapenems and antipseudomonal agents in the short-term. Thus, our initial evaluation has suggested that AS programs that use APBSS surveillance data can contribute to the appropriate use of antimicrobial agents.

Source: Journal of Pharmaceutical Health Care and Sciences

DOI: 10.1186/s40780-025-00528-0