Antibiotic stewardship highly effective in reducing drug-resistant bacteria, C. diff infections

There is a strong association between antibiotic stewardship programs and lowered rates of antibiotic-resistant bacteria and Clostridium difficile infections among hospital inpatients, a study, published in The Lancet Infectious Diseases, shows.

Researchers searched PubMed, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, and Web of Science for studies focused on effect of antibiotic stewardship programs on incidence of antibiotic-resistant bacteria and C. diff colonization and infections. The studies were published between Jan 1, 1960, and May 31, 2016. They excluded studies involving long-term care facilities.

The research team examined 32 studies that met their criteria, comprising more than 9 million patient-days and 159 estimates of incidence ratios.

The study shows antibiotic stewardship programs reduced the incidence of infections and colonization with:

●    Multidrug-resistant Gram-negative bacteria by 51 percent.
●    Extended-spectrum β-lactamase-producing Gram-negative bacteria by 48 percent
●    Meticillin-resistant Staphylococcus aureus by 37 percent

The programs also reduced the incidence of C. diff infections by 32 percent.

Additionally, researchers found that antibiotic stewardship programs were more effective when implemented with infection control measures, especially hand-hygiene interventions, than when implemented alone.

However, antibiotic stewardship did not affect the incidence ratios of vancomycin-resistant enterococci and quinolone-resistant and aminoglycoside-resistant Gram-negative bacteria.

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