Objective: To describe the implementation of a multi-step antimicrobial stewardship program in a haemato-oncology and stem cell transplantation program unit. Methods: Pre-post quasi-experimental study with two interrupted time-series analyses, conducted between 01/01/2019 and 31/12/2022 in the Paediatric Haemato-Oncology Unit of the Padua Paediatric Hospital. The interventions were: (1) 02/2020: dissemination of febrile neutropenia clinical pathways, (2) April 2021: provision of the clinical pathways via a customized App (Firstline.org) and implementation of a twice-a-week prospective audit and feedback. The main outcome was antibiotic consumption measured by days of administered therapy (DOTs)/1000 patients' days for all antibiotics and most used molecules. Results: The first intervention (clinical pathways) resulted in a decrease in the overall antibiotic use by the haemato-oncology unit, with an abrupt reduction of 3-gen cephalosporins in favor of piperacillin-tazobactam, as indicated by the clinical pathways. Meropenem and glycopeptide use did not vary. The second intervention (antimicrobial stewardship) further decreased total antibiotic consumption, and a significant decline in meropenem, amikacin, and glycopeptides was achieved. Conclusions: Multi-step stewardship based on guidelines dissemination, multidisciplinary team intervention and collaboration ("handshake" stewardship) was highly effective in optimizing guidelines adherence and reducing overprescriptions in a fragile patient cohort.
Note:
Cecilia Liberati, Elisa Barbieri share first authorship. Alessandra Biffi and Daniele Donà share last authorship.
Id prodotto:
142845
Handle IRIS:
11562/1145887
ultima modifica:
30 gennaio 2025
Citazione bibliografica:
Liberati, Cecilia; Barbieri, Elisa; Cavagnero, Francesca; Petris, Maria Grazia; Brigadoi, Giulia; Reggiani, Giulia; De Pieri, Marica; Pierobon, Marta; Marzollo, Antonio; Gabelli, Maria; Trivellato, Sabrina; Rigotti, Erika; Opri, Francesca; Mengato, Daniele; Venturini, Francesca; De Canale, Ettore; Del Vecchio, Claudia; Giaquinto, Carlo; Carrara, Elena; Tacconelli, Evelina; Biffi, Alessandra; Donà, Daniele,
Impact of a two step antimicrobial stewardship program in a paediatric haematology and oncology unit«SCIENTIFIC REPORTS»
, vol. 14
, n. 1
, 2024
, pp. 1-11