Impact of Hospital Antimicrobial Stewardship Team on Antimicrobial Usage in Regional Clinics: A Multicenter Retrospective Study.

BACKGROUND

Reports on antimicrobial stewardship teams, including hospital pharmacists, contributing to the appropriate use of antimicrobials in community clinics remain unclear. This study aimed to evaluate the impact of these series of initiatives on the appropriate use of antimicrobials in the community.

METHODS

This retrospective multicenter study was conducted at community clinics belonging to the Seto-Asahi Medical Association in Japan between April 2022 and September 2024. A practice lecture about antimicrobial stewardship was started to promote community antimicrobial stewardship in November 2022 by an antimicrobial stewardship team at Tosei General Hospital. The primary outcome was the change in the monthly usage of oral penicillins, third-generation cephalosporins, quinolones, and macrolides during the study period.

RESULTS

A total of 12 community clinics in the Seto-Asahi area were eligible. Using interrupted time series analysis, the days of therapy (DOT) for penicillins showed a statistically increased trend from period 1 (pre-promoting community antimicrobial stewardship) to period 2 (promoting community antimicrobial stewardship); the change of slope was from -0.24 to 0.13 (P = 0.03). For the DOT of third-generation cephalosporins, quinolones, and macrolides, there were no statistically significant differences in the levels or trend slopes. The DOT for the Access group increased from 2.03 (10.7%) in period 1 to 4.05 (18.9%) in period 2 (P < 0.01).

CONCLUSION

Promoting the appropriate use of antimicrobials through a hospital antimicrobial stewardship team in local community clinics played an important role in reducing the use of broad-spectrum antimicrobials.