Effects of Group 1 versus Group 2 carbapenems on the susceptibility of Acinetobacter baumannii to carbapenems: A before and after intervention study of carbapenem-use stewardship

Young Kyung Yoon, Kyung Sook Yang, Seung Eun Lee, Hyun Jeong Kim, Jang Wook Sohn, Min Ja Kim

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Objective: Antimicrobial stewardship programs have been proposed for reducing bacterial resistance in the hospital environment. The purpose of this study was to investigate the impact of a carbapenem-use stewardship program on the susceptibility of Acinetobacter baumannii to Group 2 carbapenems. Methods: A before and after intervention study was conducted at a university hospital from September 2008 to February 2013. Three study periods were defined: Phase I, pre-intervention (months 1-18); Phase II, a postintervention period during which ertapenem use was mandated but carbapenem use was not restricted (months 19-36); and Phase III, a postintervention period during which Group 2 carbapenem use was restricted (months 37-54). Results: During the study period, intervention resulted in diminished consumption of Group 2 carbapenems (antimicrobial use density (AUD): 21.3±6.0 in Phase I, 18.8±6.0 in Phase II, 16.1±4.4 in Phase III; P = 0.028) and increased consumption of ertapenem (AUD: 2.7±1.7 in Phase I, 7.2±4.5 in Phase II, 9.1±5.3 in Phase III; P<0.001). The use of autoregressive-error models showed that in contrast with ertapenem use, the use of Group 2 carbapenem during the previous one month was positively and significantly associated with a subsequent increase in the proportion of carbapenem-resistant A. baumannii (CRAB) (P = 0.031). Conclusions: Implementing a carbapenem-use stewardship program featuring the preferential use of ertapenem for treating appropriate indications of infection resulted in reduced use of Group 2 carbapenems and had a positive impact on the susceptibility of A. baumannii to carbapenems. This approach could be integrated into CRAB-control strategies in hospitals.

Original languageEnglish
Article numbere99101
JournalPloS one
Volume9
Issue number6
DOIs
Publication statusPublished - 2014 Jun 9

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)
  • General

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