Skip to main content

Antimicrobial Stewardship Program Aims to Reduce Antimicrobial Usage in Geriatric Patients without Affecting Outcomes

Literature is limited in regard to evaluating antimicrobial stewardship program (ASP) outcomes in patients aged ≥65 years. Researchers performed a retrospective chart review of 461 patients (150 control and 311 intervention) to compare the rates of 30-day readmissions of patients aged ≥65 years who received ASP interventions with a control sample who received antibiotics pre-ASP.

Patients were included if they received antibiotics for pneumonia (PNA), urinary tract infection (UTI), acute bacterial skin and skin structure infection (ABSSSI), and complicated intra-abdominal infection (cIAI). Interventions consisted of de-escalation of empiric or definitive therapy, change in duration of therapy, or discontinuation of therapy. Treatment failure was defined as readmission due to reinfection or development of a new infection (eg, Clostridium difficile).

The 30-day readmission rate for all infections decreased during the intervention period (10.7% vs 3.9%; P = .004). There was a statistically significant decrease in 30-day readmissions in the PNA subgroup (9.8% vs 2.9%; P = .038), a marginally significant decrease among patients with UTI (12.5% vs 4.7%; P = .097), and no statistically significant change in the ABSSSI (5.6% vs 8.6%; P = .694) and cIAI (20.8% vs 6.7%; P = .233) subgroups. The total adjusted patient-days (APDs) were 16,267 (control) and 15,487 (intervention). Total antimicrobial expenditure during the control period was $379,643 ($23.33/APD) versus $67,721 ($4.37/APD) during the intervention period.

ASP efforts did not lead to an increased rate of 30-day readmissions due to treatment failure. Furthermore, there was a statistically significant decrease in readmission rates in the intervention group, as well as a large decrease in antimicrobial expenditure per APD.

Source: Mauro J, et al. IDWeek 2018. Abstract 246.

Related Items
Health-Related Social Vulnerabilities in a Pediatric Outpatient Antimicrobial Therapy Program
Conference Correspondent published on October 5, 2018 in IDWeek 2018
The AMMO Study: Antimicrobial Management in Extracorporeal Membrane Oxygenation
Conference Correspondent published on October 5, 2018 in IDWeek 2018
Systematic Review and Network Meta-Analysis of Randomized Trials of Antibiotic Therapy for Community-Acquired Pneumonia
Conference Correspondent published on October 5, 2018 in IDWeek 2018
LEAP 2 Study Shows Oral Lefamulin Is Safe and Effective in Treatment of Adults with Community-Acquired Bacterial Pneumonia
Conference Correspondent published on October 5, 2018 in IDWeek 2018
Pooled Analysis of Safety Data from Phase 2 and 3 Clinical Trials Evaluating Eravacycline in Complicated Intra-Abdominal Infections
Conference Correspondent published on October 5, 2018 in IDWeek 2018
Last modified: August 30, 2021