Automated surveillance of antimicrobial consumption in intensive care, northern Sweden: an observational case study
Abstract Background The digitalization of information systems allows automatic measurement of antimicrobial consumption (AMC), helping address antibiotic resistance from inappropriate drug use without compromising patient safety. Objectives Describe and characterize a new automated AMC surveillance...
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ftdoajarticles:oai:doaj.org/article:b63e0854ea564f8382d34a7aaa315da8 2024-09-15T18:26:05+00:00 Automated surveillance of antimicrobial consumption in intensive care, northern Sweden: an observational case study Andreas Winroth Mattias Andersson Peter Fjällström Anders F. Johansson Alicia Lind 2024-06-01T00:00:00Z https://doi.org/10.1186/s13756-024-01424-2 https://doaj.org/article/b63e0854ea564f8382d34a7aaa315da8 EN eng BMC https://doi.org/10.1186/s13756-024-01424-2 https://doaj.org/toc/2047-2994 doi:10.1186/s13756-024-01424-2 2047-2994 https://doaj.org/article/b63e0854ea564f8382d34a7aaa315da8 Antimicrobial Resistance and Infection Control, Vol 13, Iss 1, Pp 1-12 (2024) Automated surveillance Intensive care Antibiotics Antimicrobial consumption Antimicrobial stewardship Antimicrobial resistance Infectious and parasitic diseases RC109-216 article 2024 ftdoajarticles https://doi.org/10.1186/s13756-024-01424-2 2024-08-05T17:49:08Z Abstract Background The digitalization of information systems allows automatic measurement of antimicrobial consumption (AMC), helping address antibiotic resistance from inappropriate drug use without compromising patient safety. Objectives Describe and characterize a new automated AMC surveillance service for intensive care units (ICUs), with data stratified by referral clinic and linked with individual patient risk factors, disease severity, and mortality. Methods An automated service collecting data from the electronic medical record was developed, implemented, and validated in a healthcare region in northern Sweden. We performed an observational study from January 1, 2018, to December 31, 2021, encompassing general ICU care for all ≥18-years-olds in a catchment population of 270000 in secondary care and 900000 in tertiary care. We used descriptive analyses to associate ICU population characteristics with AMC outcomes over time, including days of therapy (DOT), length of therapy, defined daily doses, and mortality. Results There were 5608 admissions among 5190 patients with a median age of 65 (IQR 48-75) years, 41.2% females. The 30-day mortality was 18.3%. Total AMC was 1177 DOTs in secondary and 1261 DOTs per 1000 patient days and tertiary care. AMC varied significantly among referral clinics, with the highest total among 810 general surgery admissions in tertiary care at 1486 DOTs per 1000 patient days. Case-mix effects on the AMC were apparent during COVID-19 waves highlighting the need to account for case-mix. Patients exposed to more than three antimicrobial drug classes (N = 242) had a 30-day mortality rate of 40.6%, with significant variability in their expected rates based on admission scores. Conclusion We introduce a new service and instructions for automating local ICU-AMC data collection. The versatile long-term ICU-AMC metrics presented, covering patient factors, referral clinics and mortality outcomes, are expected to be beneficial in refining antimicrobial drug use. Article in Journal/Newspaper Northern Sweden Directory of Open Access Journals: DOAJ Articles Antimicrobial Resistance & Infection Control 13 1 |
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Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Automated surveillance Intensive care Antibiotics Antimicrobial consumption Antimicrobial stewardship Antimicrobial resistance Infectious and parasitic diseases RC109-216 |
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Automated surveillance Intensive care Antibiotics Antimicrobial consumption Antimicrobial stewardship Antimicrobial resistance Infectious and parasitic diseases RC109-216 Andreas Winroth Mattias Andersson Peter Fjällström Anders F. Johansson Alicia Lind Automated surveillance of antimicrobial consumption in intensive care, northern Sweden: an observational case study |
topic_facet |
Automated surveillance Intensive care Antibiotics Antimicrobial consumption Antimicrobial stewardship Antimicrobial resistance Infectious and parasitic diseases RC109-216 |
description |
Abstract Background The digitalization of information systems allows automatic measurement of antimicrobial consumption (AMC), helping address antibiotic resistance from inappropriate drug use without compromising patient safety. Objectives Describe and characterize a new automated AMC surveillance service for intensive care units (ICUs), with data stratified by referral clinic and linked with individual patient risk factors, disease severity, and mortality. Methods An automated service collecting data from the electronic medical record was developed, implemented, and validated in a healthcare region in northern Sweden. We performed an observational study from January 1, 2018, to December 31, 2021, encompassing general ICU care for all ≥18-years-olds in a catchment population of 270000 in secondary care and 900000 in tertiary care. We used descriptive analyses to associate ICU population characteristics with AMC outcomes over time, including days of therapy (DOT), length of therapy, defined daily doses, and mortality. Results There were 5608 admissions among 5190 patients with a median age of 65 (IQR 48-75) years, 41.2% females. The 30-day mortality was 18.3%. Total AMC was 1177 DOTs in secondary and 1261 DOTs per 1000 patient days and tertiary care. AMC varied significantly among referral clinics, with the highest total among 810 general surgery admissions in tertiary care at 1486 DOTs per 1000 patient days. Case-mix effects on the AMC were apparent during COVID-19 waves highlighting the need to account for case-mix. Patients exposed to more than three antimicrobial drug classes (N = 242) had a 30-day mortality rate of 40.6%, with significant variability in their expected rates based on admission scores. Conclusion We introduce a new service and instructions for automating local ICU-AMC data collection. The versatile long-term ICU-AMC metrics presented, covering patient factors, referral clinics and mortality outcomes, are expected to be beneficial in refining antimicrobial drug use. |
format |
Article in Journal/Newspaper |
author |
Andreas Winroth Mattias Andersson Peter Fjällström Anders F. Johansson Alicia Lind |
author_facet |
Andreas Winroth Mattias Andersson Peter Fjällström Anders F. Johansson Alicia Lind |
author_sort |
Andreas Winroth |
title |
Automated surveillance of antimicrobial consumption in intensive care, northern Sweden: an observational case study |
title_short |
Automated surveillance of antimicrobial consumption in intensive care, northern Sweden: an observational case study |
title_full |
Automated surveillance of antimicrobial consumption in intensive care, northern Sweden: an observational case study |
title_fullStr |
Automated surveillance of antimicrobial consumption in intensive care, northern Sweden: an observational case study |
title_full_unstemmed |
Automated surveillance of antimicrobial consumption in intensive care, northern Sweden: an observational case study |
title_sort |
automated surveillance of antimicrobial consumption in intensive care, northern sweden: an observational case study |
publisher |
BMC |
publishDate |
2024 |
url |
https://doi.org/10.1186/s13756-024-01424-2 https://doaj.org/article/b63e0854ea564f8382d34a7aaa315da8 |
genre |
Northern Sweden |
genre_facet |
Northern Sweden |
op_source |
Antimicrobial Resistance and Infection Control, Vol 13, Iss 1, Pp 1-12 (2024) |
op_relation |
https://doi.org/10.1186/s13756-024-01424-2 https://doaj.org/toc/2047-2994 doi:10.1186/s13756-024-01424-2 2047-2994 https://doaj.org/article/b63e0854ea564f8382d34a7aaa315da8 |
op_doi |
https://doi.org/10.1186/s13756-024-01424-2 |
container_title |
Antimicrobial Resistance & Infection Control |
container_volume |
13 |
container_issue |
1 |
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1810466543676424192 |