Long-term impact of competitive biddings and an antimicrobial stewardship program in a general hospital in Chile

Autores/as

  • Alberto Fica Cubillos Hospital Base Valdivia
  • Claudia Valenzuela Hospital Militar de Santiago
  • Ignacio Leiva Hospital Militar de Santiago
  • Teresa Vergara Hospital Militar de Santiago
  • Andrés Soto Hospital Militar de Santiago
  • Jeannette Dabanch Hospital Militar de Santiago
  • Patricia Magunacelaya Hospital Militar de Santiago

Palabras clave:

Antimicrobial Stewardship, Competitive Bidding, Drug Resistance, Bacterial

Resumen

Background: The long-term effect of an antimicrobial stewardship program (ASP) and its integrated impact with competitive biddings have been seldom reported. Aim: To evaluate the long-term effect of an ASP on antimicrobial consumption, expenditure, antimicrobial resistance and hospital mortality. To estimate the contribution of competitive biddings on cost-savings. Material and methods: A comparison of periods prior (2005-2008) and posterior to ASP initiation (2009 and 2015) was done. An estimation of cost savings attributable to ASP and to competitive biddings was also performed. Results: Basal median antimicrobial consumption decreased from 221.3 to 170 daily defined doses /100 beds after the start of the ASP. At the last year, global antimicrobial consumption declined by 28%. Median antimicrobial expenditure per bed (initially US$ 13) declined to US$ 10 at the first year (-28%) and to US$ 6 the last year (-57%). As the reduction in consumption was lower than the reduction in expenditure during the last year, we assumed that only 48.4% of savings were attributable to the ASP. According to antimicrobial charges per bed from prior and after ASP implementation, we estimated global savings of US$ 393072 and US$ 190000 directly attributable to the ASP, difference explained by parallel competitive biddings. Drug resistance among nosocomial bacterial isolates did not show significant changes. Global and infectious disease-associated mortality per 1000 discharges significantly decreased during the study period (p<0.05). Conclusions: The ASP had a favorable impact on antimicrobial consumption, savings and mortality rates but did not have effect on antimicrobial resistance in selected bacterial strains.

Biografía del autor/a

Alberto Fica Cubillos, Hospital Base Valdivia

SubDepartamento de Medicina, Médico Infectólogo

Claudia Valenzuela, Hospital Militar de Santiago

Dirección Médica, Químico Farmacéutico

Ignacio Leiva, Hospital Militar de Santiago

Servicio de Farmacia, Químico Farmacéutico

Teresa Vergara, Hospital Militar de Santiago

Enfermera Unidad IAAS

Andrés Soto, Hospital Militar de Santiago

Unidad de Infectología, Médico Infectólogo

Jeannette Dabanch, Hospital Militar de Santiago

Unidad de Infectología y Unidad IAAS, Médico Infectólogo

Patricia Magunacelaya, Hospital Militar de Santiago

Unidad Bioestadística, Bioestadístico

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Publicado

2018-07-24

Cómo citar

Fica Cubillos, A., Valenzuela, C., Leiva, I., Vergara, T., Soto, A., Dabanch, J., & Magunacelaya, P. (2018). Long-term impact of competitive biddings and an antimicrobial stewardship program in a general hospital in Chile. Revista Médica De Chile, 146(9). Recuperado a partir de https://www.revistamedicadechile.cl/index.php/rmedica/article/view/6560

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