Table 2 Changing trends of antibiotic use after the major intervention (restrictive measure for designated antibiotics) and the minor intervention (monitoring for unnecessary double anaerobic coverage prescription).

From: Impact of an infectious diseases specialist-led antimicrobial stewardship programmes on antibiotic use and antimicrobial resistance in a large Korean hospital

 

Major intervention

Minor intervention

Change in levela

SE

95% CI

P

Change in trendb

SE

95% CI

P

Change in trendb

SE

95% CI

P

General wards

Antibiotics against MDR pathogens

Carbapenems

−30.58

11.14

(−53.98 to −7.18)

0.013

−7.04

2.20

(−11.66 to −2.42)

0.005

3.76

2.21

(0.89 to 8.41)

0.106

Glycopeptides

8.52

6.17

(21.48 to 4.44)

0.184

−6.01

1.24

(−8.62 to −3.40)

<0.001

4.99

1.39

(2.07 to 7.91)

0.002

Oxazolidinone

0.15

1.98

(4.02 to 4.31)

0.942

0.43

0.36

(1.19 to 0.33)

0.248

0.07

0.36

(0.68 to 0.83)

0.841

Polymyxin

3.48

2.05

(7.78 to 0.82)

0.106

0.14

0.37

(0.92 to 0.63)

0.702

1.19

0.55

(0.04 to 2.34)

0.043

Tigecycline

4.96

3.82

(3.06 to 12.98)

0.210

0.24

0.65

(1.62 to 1.13)

0.712

0.41

0.77

(1.21 to 2.02)

0.601

Subtotal

−37.47

15.69

(−70.44 to −4.50)

0.028

−13.87

3.20

(−20.59 to −7.16)

<0.001

10.43

3.31

(3.47 to 17.38)

0.006

Broad-spectrum antibiotics

3rd CEPs

13.86

12.18

(11.72 to 39.44)

0.270

−6.09

2.32

(−10.95 to −1.22)

0.017

0.52

2.47

(4.67 to 5.72)

0.835

4th CEPs

3.66

4.82

(6.46 to 13.79)

0.457

2.88

1.10

(0.55 to 5.20)

0.018

−5.95

1.22

(−8.51 to −3.38)

<0.001

BL/BLIs

50.30

16.2

(16.26 to 84.33)

0.006

2.83

3.39

(9.95 to 4.28)

0.414

7.23

3.96

(15.55 to 1.10)

0.085

FQs

1.54

8.57

(16.46 to 19.55)

0.859

−7.77

2.18

(−12.35 to −3.20)

0.002

1.40

3.67

(6.32 to 9.11)

0.708

Subtotal

69.37

23.35

(20.30 to 118.44)

0.008

−13.82

4.57

(−23.41 to −4.22)

0.007

11.25

8.66

(29.45 to 6.94)

0.210

Non-broad-spectrum antibiotics

1st CEPs

0.84

15.79

(34.02 to 32.34)

0.958

0.61

2.89

(6.68 to 5.46)

0.836

9.65

3.52

(2.26 to 17.04)

0.013

2nd CEPs

1.76

13.63

(30.39 to 26.88)

0.899

5.12

2.70

(0.55 to 10.80)

0.074

−4.80

2.74

(−12.56 to −1.03)

0.023

AGs

3.19

3.72

(4.63 to 11.02)

0.402

0.64

0.65

(0.73 to 2.00)

0.341

−4.54

1.58

(−7.86 to −1.22)

0.01

Lincosamide

5.72

3.38

(1.38 to 12.82)

0.108

0.09

0.79

(1.56 to 1.75)

0.906

0.33

0.95

(2.33 to 1.66)

0.728

Macrolides

38.26

21.62

(7.17 to 83.69)

0.084

1.30

4.51

(8.19 to 10.78)

0.777

3.58

4.08

(12.15 to 4.98)

0.391

Metronidazole

9.34

14.54

(39.90 to 21.22)

0.529

1.23

2.32

(6.12 to 3.65)

0.603

−13.86

2.61

(−19.34 to −8.38)

<0.001

Monobactam

1.68

0.89

(0.19 to 3.55)

0.076

−0.34

0.15

(−0.65 to −0.02)

0.036

0.26

0.17

(0.10 to 0.62)

0.146

Penicillins

4.16

3.81

(3.84 to 12.17)

0.289

0.14

0.70

(1.34 to 1.62)

0.845

0.83

0.88

(1.01 to 2.67)

0.357

Tetracyclines

4.01

3.25

(9.36 to 33.62)

0.233

0.13

0.65

(4.56 to 2.31)

0.847

0.80

0.66

(3.52 to 3.86)

0.238

SXT

12.13

10.23

(2.82 to 10.85)

0.251

1.13

1.63

(1.50 to 1.24)

0.499

0.17

1.76

(0.58 to 2.19)

0.925

Subtotal

57.22

34.63

(15.54 to 129.99)

0.116

3.86

7.84

(12.62 to 20.34)

0.629

−17.40

7.78

(−33.74 to −1.06)

0.038

Total

89.12

42.46

(−0.09 to 178.34)

0.050

−23.83

9.40

(−43.59 to −4.08)

0.021

18.23

10.86

(41.05 to 4.59)

0.111

Intensive care units

Antibiotics against MDR pathogens

Carbapenems

−449.90

91.91

(−642.99 to −256.81)

<0.001

−51.89

18.53

(−90.83 to −12.95)

0.012

12.08

18.56

(26.90 to 51.07)

0.523

Glycopeptides

−299.73

90.48

(−489.83 to−109.64)

0.004

−37.64

16.06

(−71.37 to −3.90)

0.031

0.94

14.55

(29.63 to 31.51)

0.949

Oxazolidinone

3.33

3.97

(11.68 to 5.02)

0.413

0.92

1.16

(1.52 to 3.35)

0.439

−7.35

1.42

(−10.33 to −4.38)

<0.001

Polymyxin

53.60

34.19

(125.43 to 18.24)

0.134

6.57

6.04

(19.27 to 6.13)

0.291

6.32

6.98

(8.34 to 20.98)

0.377

Tigecycline

49.93

25.86

(10.41 to 98.26)

0.107

0.38

5.14

(11.18 to 10.42)

0.942

12.18

6.12

(0.67 to 25.04)

0.062

Subtotal

−762.64

178.52

(−1137.70 to −387.58)

<0.001

−95.56

32.5

(−163.83 to −27.29)

0.009

24.18

31.59

(42.18 to 90.54)

0.454

Broad-spectrum antibiotics

3rd CEPs

59.89

82.56

(113.57 to 233.35)

0.478

18.95

17.00

(54.68 to 16.77)

0.280

35.8

20.14

(6.51 to 78.11)

0.092

4th CEPs

2.89

22.77

(44.96 to 50.74)

0.900

13.82

7.49

(1.92 to 29.56)

0.082

9.74

8.90

(28.44 to 8.95)

0.288

BL/BLIs

49.61

108.13

(177.35 to 276.57)

0.652

8.96

17.04

(44.75 to 26.84)

0.606

12.71

17.54

(24.15 to 49.57)

0.478

FQs

−216.75

85.87

(−397.15 to −36.35)

0.021

−34.8

13.95

(−64.12 to −5.49)

0.023

32.93

25.43

(20.50 to 86.36)

0.212

Subtotal

104.36

112.45

(340.62 to 131.90)

0.366

−48.89

21.78

(−94.66 to −3.13)

0.038

71.69

37.45

(6.98 to 150.37)

0.072

Non-broad-spectrum antibiotics

1st CEPs

64.69

23.56

(15.20 to 114.18)

0.013

−9.47

4.10

(−18.09 to −0.86)

0.033

22.74

5.35

(11.50 to 33.98)

<0.001

2nd CEPs

47.10

51.63

(61.36 to 155.56)

0.374

31.26

11.35

(7.43 to 55.10)

0.013

13.91

20.24

(56.44 to 28.62)

0.501

AGs

40.68

15.16

(8.82 to 72.54)

0.015

6.18

2.72

(0.47 to 11.89)

0.035

−37.87

8.53

(−55.79 to −19.94)

<0.001

Lincosamide

22.77

21.56

(22.51 to 68.06)

0.305

8.69

4.83

(1.47 to 18.84)

0.089

7.99

5.05

(18.60 to 2.62)

0.131

Macrolides

17.82

34.18

(89.64 to 53.99)

0.608

9.47

6.27

(22.64 to 3.70)

0.148

13.34

7.99

(3.45 to 30.12)

0.112

Metronidazole

119.90

73.71

(274.77 to 34.96)

0.121

6.88

14.69

(37.74 to 23.98)

0.645

13.14

21.9

(32.87 to 59.16)

0.556

Monobactam

7.11

5.69

(19.06 to 4.83)

0.227

0.00

1.15

(2.42 to 2.42)

1.000

2.23

1.51

(1.06 to 5.30)

0.179

Penicillins

10.34

8.48

(7.47 to 28.15)

0.238

2.66

2.81

(3.26 to 8.57)

0.357

6.52

4.55

(16.08 to 3.04)

0.169

Tetracyclines

3.53

7.10

(8.36 to 47.87)

0.625

2.63

2.24

(7.02 to 4.60)

0.256

2.85

2.57

(3.87 to 20.45)

0.283

SXT

28.11

9.40

(−11.39 to 18.45)

0.008

1.21

2.76

(2.08 to 7.33)

0.667

8.29

5.79

(8.25 to 2.56)

0.169

Subtotal

72.39

79.28

(94.17 to 238.95)

0.373

24.39

15.36

(7.88 to 56.66)

0.130

9.51

34.50

(81.99 to 62.97)

0.786

Total

−794.61

223.29

(−1263.73 to −325.49)

0.002

−120.06

36.17

(−196.06 to −44.06)

0.004

86.36

68.56

(57.68 to 230.39)

0.224

  1. aThe unit for change in level is days of therapy (DOT)/1,000 patient-days; bThe unit for change in trend is DOT/1,000 patient-days per month.
  2. Abbreviations: SE, Standard errors; CI, Confidence interval; MDR, multidrug-resistant; 3rd CEPs, 3rd generation cephalosporins; 4th CEPs, 4th generation cephalosporins; BL/BLIs, beta-lactam/beta-lactamase inhibitors; FQs, fluoroquinolones; 1st CEPs, 1st generation cephalosporins; 2nd CEPs, 2nd generation cephalosporins; AGs, aminoglycosides; SXT, trimethoprim/sulfamethoxazole.