Impact of an antimicrobial stewardship program on the appropriate use of carbapenems in a French university hospital (CARBACAI study) - 12/03/25
, Guillaume Saint-Lorant a, b, Aurélie Baldolli c, Christophe Isnard d, e, Pascal Thibon f, Arnaud de La Blanchardiere cHighlights |
• | Two-year prospective study using the stepped-wedge method on the use of carbapenems in a university hospital enabling a comparative study in all medical units of a hospital facility with an antimicrobial stewardship team. |
• | Significant impact on the three criteria assessed for proper use of penems (indications, dosage, and duration of treatment) on all university hospital care units compared with a first study performed in 2018 and published in Médecine et Maladies Infectieuses. |
• | Review of institutional protocols based on a multidisciplinary collaboration, particularly for hematology and neurosurgery care units using penems (new units included in this study). |
• | Comparison with other French studies on the proper use of penems based on French recommendations. |
Abstract |
Objectives |
To study compliance with national guidelines for carbapenem (CP) use.
Patients and methods |
We performed a two-year prospective monocentric and interventional study in a French university hospital. The study was based on three phases (observation (P1), intervention (P2), and post-intervention (P3)) and ended 10 months after intervention. Compliance of CP prescriptions was based on predetermined criteria.
Results |
Among the 330 prescriptions assessed, treatment adequacy on Day 3 increased from 32.3 % (n = 42/130) during phase P1 to 72.2 % (n = 70/97) during phase P3 (p < 0.01), with a significant impact on indications, dosage, and duration of treatment but not on CP choice. There were no significant changes in overall CP consumption.
Conclusions |
Implementing an educational antimicrobial stewardship program for hospital CP proper use had a positive impact. Educational reminders are essential to support these improvements.
Le texte complet de cet article est disponible en PDF.Keywords : Antimicrobial stewardship program, Appropriate use of antibiotics, Carbapenems, Extended-spectrum beta-lactamase-producing Enterobacterales, Stepped-wedge design
Plan
Vol 55 - N° 2
Article 105039- mars 2025 Retour au numéro
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