Title : Evaluating the effectiveness of antimicrobial stewardship on escherichia coli resistance in patients with urinary tract infection
Although several studies have shown that the application of antimicrobial stewardship (AMS) has a positive impact on reduction of antimicrobial resistance and therefore the clinical outcomes of patients, most of the studies were conducted some years ago, and there have been no recent reviews that specifically measures the impact of AMS on urinary tract infections caused by Escherichia coli. The purpose of this study is to evaluate the effectiveness of AMS on adult patients with urinary tract infections caused by E. coli using studies that have been published in the last 15 years.
This systematic review and meta-analysis followed the Preferred Reporting for Systematic Review and Meta-Analysis (PRISMA) guidelines. Three electronic databases were searched: EMBASE, PubMed, and Medline for studies published from 2007 to 2022.
Ten studies reported data in antimicrobial resistance following AMS intervention between 2007 and 2022. A total of 398,957 participants were included in all the studies.
A meta-analysis of all the included studies demonstrated a reduction in the antimicrobial resistance rate after AMS intervention (pooled percentage change = 3.65, P <0.05). Studies that stopped certain antibiotics or switched them to another agent without any other forms of intervention achieved the highest antimicrobial resistance reduction of 9.43% (P = 0.02).
Our findings suggested that the introduction of antimicrobial stewardship programme could reduce E. coli resistance seen in adult patients, both in the hospital and in the community, with urinary tract infections.
Audience take away:
- This systematic review validates that the methods in applying the stewardship programme and the key healthcare professionals involved can be highly variable and both aspects are important in the application of the stewardship programme.
- From this presentation, the audience will learn that the use of educational lectures and the application of audit and feedback could result to an improvement of antimicrobial resistance. This should encourage physicians to implement these methods in their clinical practice.
- ???????With regards to future research, this study shows that there is still a lack of studies on the effect of AMS in resistance and this limits us to perform various analysis on its impact in various clinical settings. This should encourage more researchers to explore this area even more and to publish their results regardless of the outcome.