Two-thirds of general medicine patients with pneumonia received excess antibiotic therapy, with 93.2% of the unnecessary duration occurring after hospital discharge. Excess antibiotic therapy did not improve mortality or morbidity outcomes, although each additional antibiotic day was associated with 3% increased odds of antibiotic-associated adverse drug events.
Antimicrobial stewardship is the responsibility of everyone involved in the care of critically ill and hospitalized patients. This review discusses some of the key principles and practices of successful antimicrobial stewardship programs, particularly as they relate to critical care.
There are some signs of progress in drug-resistant infections in pediatrics, suggesting that antibiotic stewardship efforts may be having an effect and fewer broad-spectrum agents are being used on this important patient group, the Centers for Disease Control and Prevention reports.
In patients with gram-negative rod bacteremia, patients receiving seven days of antibiotics had similar 90-day mortality, readmission rates, and rates of recurrent bacteremia as patients receiving 14 days of antibiotic.
A combination of public health, antibiotic stewardship, and infection control efforts over the last six years have managed to beat back the devil of multidrug-resistant bacteria. Yet all still hangs in the balance.
Relative to vancomycin or metronidazole treatment of recurrent Clostridioides difficile infection, treatment with fecal microbiota transplantation is associated with a reduced risk of bloodstream infection, shorter hospital length of stay, and improved survival.
In a retrospective cohort study of 350 patients, the combination of a beta-lactam antibiotic plus daptomycin was not superior to beta-lactam monotherapy in patients with bacteremia due to methicillin-susceptible Staphylococcus aureus.