{Reference Type}: Journal Article
{Title}: "Impact of the introduction of the national antimicrobial stewardship standard across Queensland Health hospitals: Ecological observational study exploring patterns of antimicrobial use."
{Author}: Holland C;Ballard E;Griffin A;Coulter S;Yarwood T;Heney C;Young M;
{Journal}: J Hosp Infect
{Volume}: 0
{Issue}: 0
{Year}: 2024 Jun 13
{Factor}: 8.944
{DOI}: 10.1016/j.jhin.2024.05.018
{Abstract}: <B>BACKGROUND: </B>Antimicrobial stewardship programs are a critical tool for addressing the rising threat of antimicrobial resistance.<BR><B>OBJECTIVE: </B>To determine changes in patterns of antimicrobial use in Queensland public hospitals following introduction of the National Safety and Quality Health Service antimicrobial stewardship standard.<BR><B>METHODS: </B>A retrospective pre/post intervention study was conducted across Queensland public hospitals at the ecological level using Queensland Health's MedTRx database. An interrupted time series analysis was performed using linear regression models to determine rates of antimicrobial use by quarterly aggregated defined daily dose per 1000 patient days, for groups of hospitals stratified by peer group classification. Pre-defined time periods for antimicrobial stewardship program implementation in response to the introduction of the standard were analysed.<BR><B>RESULTS: </B>In the post intervention period, there was a decrease in overall use of systemic antimicrobials, glycopeptides, carbapenems and fluoroquinolones in principal referral and public acute group A hospitals. A decrease in overall use was also observed for smaller regional and remote public acute group C and D hospitals, however, increases in glycopeptide and fluoroquinolone use were observed. Third generation cephalosporin use was unchanged for all hospital peer groups. The proportion of overall use that was accounted for by narrow spectrum penicillin was low for all facilities, with modest improvements in the post intervention period observed in principal referral facilities only.<BR><B>CONCLUSIONS: </B>These findings add to current knowledge on the effectiveness of legislative quality standards on antimicrobial stewardship at the macro level and highlight gaps to target for future programs.