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ANTIBIOTIC USE AND ECONOMIC IMPACT OF AN ANTIMICROBIAL STEWARDSHIP PROGRAM IN A REFERENCE PEDIATRIC HOSPITAL IN SOUTH AMERICA: 2016 – 2021
Abstract
Background
Antimicrobial Stewardship Programs (ASP) represent a strategy to optimize antimicrobial use. Different outcomes are measured as ASP impact. Days of therapy (DOT) and cost represent an important measure. Few studies in pediatric hospitals in Latin America describes economic impact of ASP.
Aims
The aim of this study is to present the impact on antibiotic use and economic impact after 5 consecutive years of an ASP in a reference pediatric hospital in South America.
Methods
This is an observational, retrospective, and descriptive study. Comparing use and costs of antimicrobial use from 2016 – 2021. Days of therapy (DOT), and direct cost of antibiotics will be used to estimate impact of ASP.
Results
In 2016, before ASP implementation, antibiotics represented US 193034. After rigorously ASP, controlling broad spectrum antibiotics(BSA) since 2017 and from 2019 including also narrow spectrum antibiotics(NSA) the total cost was 107606, a 44% reduction in total costs Graph 1. Comparing savings, NSA decreases theirs cost in 22%, while BSA 60% Graph 2. Top reductions in antibiotics costs are presented in first place by ertapenem US 9151 vs. 813 (-91%), ceftriaxone US 29080 vs. 6209 (-79%) and caspofungin US 24403 vs. 6050 (-75)Graph 3. Cost savings represent important DOT reductions since different specific interventions were implemented Graph 4.
Conclusions
An ASP program with dedicated time controlling not only BSA, in a resource limited setting achieved important cost savings. These findings should encourage others centers and administrators to implement an ASP. Costs and decrease in DOT, are only part of the real impact of ASP.