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).
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 |