Data Impact Challenge II Question 5

Question 5:  What is the reduction in antimicrobial use in hospitals with antimicrobial stewardship programs?

Rationale
Drug-resistant infections are increasing as microbes adapt to the routine use of antibiotics, resulting in significant morbidity and mortality. It is estimated that as much as 50% of antibiotic usage may be unnecessary. Promoting prudent antibiotic use in Canadian hospitals and healthcare organizations is essential to addressing antibiotic resistance.

This question seeks to understand how large a reduction in antimicrobial usage is achieved – on average – by antimicrobial stewardship programs in Canada, and whether there are there particular outliers, indicating programs that have fared particularly well or poorly.

Results

The Consortium of Antimicrobial Stewardship Programs Against Resistance (C.A.S.P.A.R.) team used data from hospitals in Ontario to look at antimicrobial consumption in both intensive care and medical/surgical inpatient units.

Guiding Specifications

The analysis should indicate the average percent reduction in daily doses of therapy (DDT) for antimicrobials in the years before and after stewardship programmes were adopted in Canadian hospitals. The benchmark for adoption of a stewardship program is compliance with Accreditation Canada’s required organizational practice for antimicrobial stewardship (http://accreditation.ca/sites/default/files/rop-handbook-2016-en.pdf – page 39).

The ideal response would be an average of percent reductions in antimicrobial use for a representative sample of Canadian hospitals that have undertaken antimicrobial stewardship programs over the past decade. It may be useful to note that Accreditation Canada recently added stewardship policies as required organizational practice in Canadian hospitals beginning in 2014.

Participating Team

CASPAR (Consortium of Antimicrobial Stewardship Programs Against Resistance)

Team bio: We are representatives from Antimicrobial Stewardship Programs at Michael Garron Hospital, Niagara Health System, Sinai Health System, and University Health Network. We joined forces to gain cross-organizational insights into antimicrobial stewardship.
Entry: PDF