Antimicrobial resistance (AMR) is a significant public health concern globally, with Italy experiencing particularly high AMR rates. Antimicrobial stewardship (AMS) programs play a crucial role in combating AMR by promoting responsible antibiotic use. The COVID-19 pandemic posed challenges to healthcare systems worldwide, potentially impacting AMS activities. This study aimed to assess the impact of the pandemic on AMS programs in Piedmont, Italy, and evaluate relevant outcomes.
Methods:
A retrospective observational study was conducted to evaluate AMS programs in acute-care trusts in Piedmont, participating in a broader healthcare-associated infections and AMR prevention program. Structure, process, and outcome indicators of AMS programs were assessed using a scoring system. Data from 2019 and 2021 were compared to analyze changes during the pandemic. Linear regression and compound annual growth rates (CAGR) were used to assess trends in outcome measures from 2017 to 2021.
Key Findings:
- AMS Program Assessment:
- Modest, non-significant improvements were observed in structure, process, and total scores from 2019 to 2021.
- Significant improvement was noted in formal mission statement definition, but fewer trusts monitored adherence to antimicrobial policy or treatment guidelines.
- Overall antibiotic consumption increased in 2021, with the highest median consumption recorded compared to previous years.
- Impact of COVID-19 on AMS Programs:
- AMS programs in Piedmont were resilient to pandemic challenges, with no setback observed following the pandemic.
- Majority of AMS programs in Piedmont utilized back-end or persuasive approaches, which may have contributed to program continuity.
- Improved commitment among AMS teams, as indicated by increased formal mission statement definition, may have facilitated program resilience.
- Outcome Measures:
- Alcohol-based handrub consumption increased over the years, while antibiotic consumption and AMR rates generally decreased or remained stable.
- Significant reductions in methicillin-resistant Staphylococcus aureus (MRSA) rates were observed, particularly in trusts with high AMS program structure and process scores.
- Antibiotic consumption rebounded in 2021, potentially influenced by changes in healthcare delivery and prescribing patterns during the pandemic.
AMS programs in Piedmont demonstrated resilience to the challenges posed by the COVID-19 pandemic, thanks to well-established programs coordinated within a regional framework. Characteristics such as program structure and team commitment may have contributed to this resilience. However, continued efforts are needed to support AMS programs and combat AMR, even amidst other public health emergencies.
Link to the article : https://tinyurl.com/bdcbaeyx
