Linking antimicrobial prescribing to antimicrobial resistance in the ICU: before and after an antimicrobial stewardship program.

摘要: Antimicrobials are an effective treatment for many types of infections, but their overuse promotes the spread resistant microorganisms that defy conventional treatments and complicate patient care. In 2009, antimicrobial stewardship program was implemented at Mount Sinai Hospital (MSH, Toronto, Canada). Components this were to alter fraction patients prescribed antimicrobials, shorten average duration treatment, antimicrobials prescribed. These components incorporated into a mathematical model compared data reporting number colonized with Pseudomonas aeruginosa antimicrobial-resistant P. first isolates before after program. Our analysis shows reported decrease in due treating fewer patients, while combined effect altering We also find shortening unlikely have produced any noticeable effects further reducing would most substantially reduce resistance future. The analytical framework we derive considers colonization pressure on infection can be used interpret clinical assess different aspects within ecological context intensive care unit.