27 Reduction of the duration of antibiotic therapy in surgery through a specific nationwide stewardship program. A prospective cohort study (2019–2022)

• DOI: 10.1093/bjs/znaf024.009
• Publication Date: 2025-02-24T17:22:03Z
• Authors: Maria Batlle; Sergi Hernández; Ariadna Padulles; Lucia Boix-Palop; Montserat Giménez; Maria Pilar Garcia; Santiago Grau; Juan P Horcajada; Josep M Badia
• Keywords: Antibiotic Stewardship; Antibiotic Therapy; Antimicrobial Stewardship

Abstract Aim Prolonged antibiotic treatments contribute to increasing antimicrobial resistance. Current guidelines recommend 5–7 days of treatment in patients with surgical infection an adequate source control. Antibiotic stewardship aim optimize the use antibiotics, including their duration. The 7VINCut nationwide intervention aims reduce duration <7 patients. Methods Prospective cohort study conducted 37 hospitals 2019–2022. Patients admitted services >7 were analysed. teams met weekly and made written recommendations electronic medical record. Indication for treatment, quality control, type issued, adherence them Temporal trends percentages those evaluated using a linear regression model Pearson's correlation coefficients. Results 44 702 examined. Of these, 6163 (13.8%) had days. A total 5606 interventions performed (90% target population), primarily general surgery (5704; 90%) urology (497; 8.9%). main sources intra-abdominal (73%), skin/soft tissues (10%) urinary (9.3%). septic focus was considered controlled only 60.2% cases. Out 6236 prescriptions, most frequently analysed drugs piperacillin/tazobactam (27.1%), metronizadole (14.4%), amoxicillin/clavulanate (12.9%), meropenem (12.8%), ceftriaxone (11.6%) ciprofloxacin (8.1%). Antibiotics high ecological impact account 68.3% prescriptions evaluated. issued were: discontinuation (34.1%), maintenance (41.0%) or de-escalation (15.3%), followed 5179 cases (adherence 92.4%). With frequent recommendation terminate (49.6%, 1673 cases). Throughout period, significant decrease percentage prolonged observed (−40.1%, Pc = −0.39; P 0.006). Conclusions program, surgeons multidisciplinary teams, achieved reduction lasting over 7 departments. majority carried out departments, beta-lactam carbapenem antibiotics. Overall by 92.4%.