Description of changes in clinical outcomes following the implementation of an antibiotic stewardship program in a level-IV hospital

Introduction: Inadequate prescription of antibiotics has been recognized as a public health problem by the World Health Organization. Antibiotic stewardship programs have been implemented as a tool to mitigate its impact.Objective: To describe the changes in clinical outcomes following the implementation of an antibiotic stewardship program in a level-IV hospital.Material and methods: This is a unique cohort study of patients hospitalized for infectious pathologies and treated with antibiotics in an advanced medical facility. First, the history prior to the implementation of the antibiotic stewardship program (2013 to 2015) was collected, and then records from 2018 to 2019 were compared after the implementation of the program, evaluating changes in clinical outcomes such as overall mortality, hospital stay, among others.Results: A total of 1,066 patients were analyzed, 266 in the pre-implementation group and 800 in the post-implementation group. The average age was 59.2 years and 62% of the population was male. Statistically significant differences were found in overall mortality (29% vs 15%; p<0.001), mortality due to infectious causes (25% vs 9%; p<0.001), and average hospital stay (45 days vs 21 days; p<0.001), with a tendency to decrease hospital re-admission at 30 days for infectious cause (14% vs 10%; p 0.085).Conclusions: The development of the Antibiotic Stewardship Program was linked to a decrease in overall mortality and mortality due to infectious causes, as well as in average hospital stay. This demonstrates the importance of developing interventions aimed at mitigating the impact of inadequate prescription of antibiotics.