Abstract

Objectives: Antimicrobial stewardship is important in the intensive care unit (ICU), where critically ill patients are managed. Herein, we aimed to evaluate the associations between the timing of antimicrobial stewardship team (AST) interventions in the ICU and patient mortality and to identify the optimal timing of interventions to improve patient survival.
Materials and methods: We retrospectively analyzed the data of patients admitted to the ICU at Showa Medical University Northern Yokohama Hospital (April 2016 – March 2023). The primary outcome was in-hospital mortality; the key exposure was the timing of AST intervention following antimicrobial initiation. Mortality incidence rates per 100 person-days and age-adjusted incidence rate ratios were calculated.
Results: Overall, 94 patients were included. Earlier AST intervention after ICU admission was associated with the lowest mortality (incidence rate (IR): 0.205 (95% confidence interval (CI): 0 – 0.512) per 100 person-days). In an age-adjusted analysis, later intervention was associated with a higher mortality incidence rate than earlier intervention (IR ratio (IRR): 5.53 (95% CI: 1.30 – 23.50), p = 0.02).
Conclusion: Earlier AST intervention after ICU admission was associated with lower mortality in ICU patients. Proactive and timely stewardship efforts are therefore needed in ICUs.

Author Details

Authors

• Akitoshi Takuma^{1, 2}
• Airi Miura^{2, 3}
• Kotono Tagami²
• Kenji Momo⁴

Departments

• ¹ Department of Pharmacy, Showa Medical University Northern Yokohama Hospital, Tsuzuki-ku, Yokohama, Kanagawa,
• ² Division of Hospital Pharmaceutics, Department of Hospital Pharmaceutics, School of Pharmacy, Showa Medical University, Shinagawa-ku,
• ³ Department of Pharmacy, Kanagawa Rehabilitation Hospital, Kanagawa Rehabilitation Center, Atsugi-shi, Kanagawa, and
• ⁴ Division of Clinical Research, Department of Hospital Pharmaceutics, School of Pharmacy, Showa Medical University, Shinagawa-ku, Tokyo, Japan

Address

Dr. Akitoshi Takuma
Department of Pharmacy
Showa Medical University Northern Yokohama Hospital
Chigasaki Chuo 35-1, Tsuzuki-ku,
Yokohama, Kanagawa 224-8503, Japan
Email: [email protected]

Citation