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Peñalva, Germán; Crespo-Rivas, Juan Carlos; Guisado-Gil, Ana Belén; Rodríguez-Villodres, Ángel; Pachón-Ibáñez, María Eugenia; Cachero-Alba, Bárbara; Rivas-Romero, Blas; Gil-Moreno, Josefa; Galvá-Borras, María Isabel; García-Moreno, Mercedes; Salamanca-Bautista, María Dolores; Martínez-Rascón, Manuel Bautista; Cantudo-Cuenca, María Rosa; Ninahuaman-Poma, Ruth Concepción; Enrique-Mirón, María de los Ángeles; Pérez-Barroso, Aurora; Marín-Ariza, Inmaculada; González-Florido, Miguel; Mora-Santiago, María del Rosario; Belda-Rustarazo, Susana; Expósito-Tirado, José Antonio; Rosso-Fernández, Clara María; Gil-Navarro, María Victoria; Lepe-Jiménez, José Antonio; [...]

Clinical and Ecological Impact of an Educational Program to Optimize Antibiotic Treatments in Nursing Homes (PROA-SENIOR): A Cluster, Randomized, Controlled Trial and Interrupted Time-Series Analysis

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  • Media type: E-Article
  • Title: Clinical and Ecological Impact of an Educational Program to Optimize Antibiotic Treatments in Nursing Homes (PROA-SENIOR): A Cluster, Randomized, Controlled Trial and Interrupted Time-Series Analysis
  • Contributor: Peñalva, Germán; Crespo-Rivas, Juan Carlos; Guisado-Gil, Ana Belén; Rodríguez-Villodres, Ángel; Pachón-Ibáñez, María Eugenia; Cachero-Alba, Bárbara; Rivas-Romero, Blas; Gil-Moreno, Josefa; Galvá-Borras, María Isabel; García-Moreno, Mercedes; Salamanca-Bautista, María Dolores; Martínez-Rascón, Manuel Bautista; Cantudo-Cuenca, María Rosa; Ninahuaman-Poma, Ruth Concepción; Enrique-Mirón, María de los Ángeles; Pérez-Barroso, Aurora; Marín-Ariza, Inmaculada; González-Florido, Miguel; Mora-Santiago, María del Rosario; Belda-Rustarazo, Susana; Expósito-Tirado, José Antonio; Rosso-Fernández, Clara María; Gil-Navarro, María Victoria; Lepe-Jiménez, José Antonio; [...]
  • imprint: Oxford University Press (OUP), 2023
  • Published in: Clinical Infectious Diseases
  • Language: English
  • DOI: 10.1093/cid/ciac834
  • ISSN: 1058-4838; 1537-6591
  • Origination:
  • Footnote:
  • Description: <jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Antimicrobial stewardship programs (ASPs) are recommended in nursing homes (NHs), although data are limited. We aimed to determine the clinical and ecological impact of an ASP for NHs.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We performed a cluster, randomized, controlled trial and a before–after study with interrupted time-series analyses in 14 NHs for 30 consecutive months from July 2018 to December 2020 in Andalusia, Spain. Seven facilities implemented an ASP with a bundle of 5 educational measures (general ASP) and 7 added 1-to-1 educational interviews (experimental ASP). The primary outcome was the overall use of antimicrobials, calculated monthly as defined daily doses (DDD) per 1000 resident days (DRD).</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>The total mean antimicrobial consumption decreased by 31.2% (−16.72 DRD; P = .045) with respect to the preintervention period; the overall use of quinolones and amoxicillin–clavulanic acid dropped by 52.2% (P = .001) and 42.5% (P = .006), respectively; and the overall prevalence of multidrug-resistant organisms (MDROs) decreased from 24.7% to 17.4% (P = .012). During the intervention period, 12.5 educational interviews per doctor were performed in the experimental ASP group; no differences were found in the total mean antimicrobial use between groups (−14.62 DRD; P = .25). Two unexpected coronavirus disease 2019 waves affected the centers increasing the overall mean use of antimicrobials by 40% (51.56 DRD; P &amp;lt; .0001).</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>This study suggests that an ASP for NHs appears to be associated with a decrease in total consumption of antimicrobials and prevalence of MDROs. This trial did not find benefits associated with educational interviews, probably due to the coronavirus disease 2019 pandemic.</jats:p><jats:p>Clinical Trials Registration. NCT03543605.</jats:p></jats:sec>
  • Access State: Open Access