AI Article Synopsis
- Over 350,000 patients are treated annually in Germany for sepsis or pneumonia, leading to high antibiotic usage and increasing drug resistance concerns.
- In a German hospital, a study was conducted to reduce antibiotic use through training and standardized protocols, resulting in significantly lower consumption rates and improved patient outcomes from 2010-2013.
- The study found that reducing antibiotics led to lower mortality rates for sepsis and pneumonia patients, as well as a decrease in drug resistance, suggesting a more targeted approach to antibiotic prescribing is beneficial.
Article Abstract
Background: Over 350 000 patients are treated in German hospitals for sepsis or pneumonia each year. The rate of antibiotic use in hospitals is high. The growing problem of drug resistance necessitates a reconsideration of antibiotic treatment strategies.
Methods: Antibiotics were given liberally in the years 2010 and 2011 in a German 312-bed hospital. Special training, standardized algorithms to prevent unnecessary drug orders, and uniform recommendations were used in 2012 and 2013 to lessen antibiotic use. We retrospectively studied the hospital's mortality figures and microbiological findings to analyze how well these measures worked.
Results: Antibiotic consumption fell from 67.1 to 51.0 defined daily doses (DDD) per 100 patient days (p <0.001) from the period 2010-2011 to the period 2012-2013. The mortality of patients with a main diagnosis of sepsis fell from 1% (95/305) to 19% (63/327; p = 0.001), while that of patients with a main diagnosis of pneumonia fell from 12% (22/178) to 6% (15/235; p = 0.038). The overall mortality fell from 3.0% (623/ 20 954) to 2.5% (576/22 719; p = 0.005). In patients with nosocomial urinary tract infections with Gram-negative pathogens (not necessarily exhibiting three- or fourfold drug resistance), the rate of resistance to three or four of the antibiotics tested fell from 11% to 5%.
Conclusion: Reducing in-hospital antibiotic use is an achievable goal and was associated in this study with lower mortality and less drug resistance. The findings of this single-center, retrospective study encourage a more limited and focused approach to the administration of antibiotics.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4644935 | PMC |
| http://dx.doi.org/10.3238/arztebl.2015.0714 | DOI Listing |
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