Multicenter Evaluation of Antibiotic Use and Antibiotic Stewardship Programs in Latin American Hospitals.
| Title: | Multicenter Evaluation of Antibiotic Use and Antibiotic Stewardship Programs in Latin American Hospitals. |
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| Authors: | Fabre V; Division of Infectious Diseases, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.; Cosgrove SE; Division of Infectious Diseases, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.; Hsu YJ; Department of Health Policy and Management, Johns Hopkins Bloomberg of School of Public Health, Baltimore, Maryland, USA.; Patel TS; International Infection Control Branch, Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.; Lessa FC; International Infection Control Branch, Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.; Alvarado A; Unidad de Cirugia Cardiovascular de Guatemala, Guatemala, Guatemala.; Aquiles B; Hospital Sociedad de Lucha Contra el Cáncer, Guayaquil, Ecuador.; Arauz AB; Departamento de Medicina, Universidad de Panamá, Panama.; Hospital Santo Tomas, Panama, Panama.; Barberis MF; Hospital Nacional Profesor Alejandro Posadas, El Palomar, Argentina.; Bangher MDC; Instituto de Cardiología de Corrientes 'Juana Francisca Cabral,' Corrientes, Argentina.; Bernachea MP; Clínica Conciencia, Neuquén, Argentina.; Bernan ML; Hospital Interzonal General de Agudos San Roque, Buenos Aires, Argentina.; Canton A; Hospital Punta Pacífica Salud, Panamá, Panama.; Castañeda X; Clínica De La Mujer, Bogotá, Colombia.; Hospital Mederi, Bogota, Colombia.; Colque AM; Complejo Médico Churruca Visca, Buenos Aires, Argentina.; Contreras R; Hospital Dr Marcial V. Quiroga, San Juan, Argentina.; Cornistein W; Hospital Universitario Austral, Buenos Aires, Argentina.; Correa SM; Hospital Municipal de Trauma Dr Federico Abete, Malvinas Argentinas, Argentina.; Costilla Campero G; Hospital Angel C. Padilla, Tucumán, Argentina.; Chamorro Ayala MI; Hospital Zonal General de Agudos Dr Alberto Eurnekian, Buenos Aires, Argentina.; Espinola L; Hospital El Cruce, Buenos Aires, Argentina.; Esquivel C; Hospital San Benito, Peten, Guatemala.; Ezcurra C; Hospital Alemán, Buenos Aires, Argentina.; Fernandez J; Hospital Dr Guillermo Rawson, San Juan, Argentina.; Ferrari S; Hospital Dr Guillermo Rawson, San Juan, Argentina.; Frassone N; Clínica Universitaria Privada Reina Fabiola, Córdoba, Argentina.; Garcia Cruz C; Hospital Sociedad de Lucha Contra el Cáncer, Guayaquil, Ecuador.; Garzón MI; Hospital Privado Universitario de Córdoba, Córdoba, Argentina.; Gomez Quintero CH; Clínica De La Mujer, Bogotá, Colombia.; Hospital Militar Central, Bogotá, Colombia.; Gonzalez JA; Hospital Irma de Lourdes Tzanetatos, Panama, Panama.; Guaymas L; Clínica Provincial de Merlo, Buenos Aires, Argentina.; Guerrero-Toapanta F; Hospital Carlos Andrade Marín, Quito, Ecuador.; Lambert S; Hospital El Cruce, Buenos Aires, Argentina.; Laplume D; Hospital Nacional Profesor Alejandro Posadas, El Palomar, Argentina.; Lopez IL; Clínica Hospital San Fernando, Panama, Panama.; Maldonado H; Unidad de Cirugia Cardiovascular de Guatemala, Guatemala, Guatemala.; Universidad del Valle de Guatemala, Guatemala, Guatemala.; Mañez N; Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.; Maurizi DM; Hospital Municipal de Agudos Dr Leonidas Lucero, Bahía Blanca, Argentina.; Melgar M; Hospital Roosevelt, Guatemala, Guatemala.; Mesplet F; Hospital Cesar Milstein, Buenos Aires, Argentina.; Morales Pertuz C; Hospital Del Tunal, Bogotá, Colombia.; Moreno Izquierdo C; Hospital Metropolitano, Quito, Ecuador.; Moya LG; Clínica Conciencia, Neuquén, Argentina.; Nuccetelli Y; Instituto de Diagnostico, La Plata, Argentina.; Núñez G; Hospital Santo Tomas, Panama, Panama.; Olmedo A; Hospital Punta Pacífica Salud, Panamá, Panama.; Palacio B; Sanatorio Allende Nueva Córdoba, Córdoba, Argentina.; Pauluzzi A; Hospital Universitario Austral, Buenos Aires, Argentina.; de Paz Sierra M; Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.; Pellice F; Hospital Dr Marcial V. Quiroga, San Juan, Argentina.; Perez Alvear L; Hospital Del Tunal, Bogotá, Colombia.; Raffo CL; Hospital Municipal de Trauma Dr Federico Abete, Malvinas Argentinas, Argentina.; Reino F; Hospital Carlos Andrade Marín, Quito, Ecuador.; Vence Reyes L; The Panama Clinic, Panama, Panama.; Ricoy G; Complejo Médico Churruca Visca, Buenos Aires, Argentina.; Rodriguez VE; Hospital Alemán, Buenos Aires, Argentina.; Romero F; Sanatorio Allende Nueva Córdoba, Córdoba, Argentina.; Romero JJ; Hospital Vozandes, Quito, Ecuador.; Ruiz M; Hospital Cesar Milstein, Buenos Aires, Argentina.; Russo ME; Hospital Interzonal General de Agudos San Roque, Buenos Aires, Argentina.; Sadino G; Clínica Universitaria Privada Reina Fabiola, Córdoba, Argentina.; Sandoval N; Hospital Roosevelt, Guatemala, Guatemala.; Staffolani N; Maternidad Nuestra Señora De Las Mercedes De Tucumán, Tucumán, Argentina.; Torralvo MJ; Hospital Mederi, Bogota, Colombia.; Urueña AM; Maternidad Nuestra Señora De Las Mercedes De Tucumán, Tucumán, Argentina.; Videla H; Instituto de Diagnostico, La Plata, Argentina.; Valle M; Hospital Municipal de Agudos Dr Leonidas Lucero, Bahía Blanca, Argentina.; Vera Amate Perez S; Hospital Angel C. Padilla, Tucumán, Argentina.; Vergara-Samur H; Hospital Militar Central, Bogotá, Colombia.; Villamandos S; Instituto de Cardiología de Corrientes 'Juana Francisca Cabral,' Corrientes, Argentina.; Villarreal O; Hospital Irma de Lourdes Tzanetatos, Panama, Panama.; Warley E; Clínica Provincial de Merlo, Buenos Aires, Argentina.; Reyes-Morales G; Division of Infectious Diseases, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.; Quiros RE; Sanatorio Las Lomas, Buenos Aires, Argentina. |
| Source: | Open forum infectious diseases [Open Forum Infect Dis] 2025 Jun 25; Vol. 12 (7), pp. ofaf364. Date of Electronic Publication: 2025 Jun 25 (Print Publication: 2025). |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Published by Oxford University Press on behalf of the Infectious Diseases Society of America Country of Publication: United States NLM ID: 101637045 Publication Model: eCollection Cited Medium: Print ISSN: 2328-8957 (Print) Linking ISSN: 23288957 NLM ISO Abbreviation: Open Forum Infect Dis Subsets: PubMed not MEDLINE |
| Imprint Name(s): | Original Publication: Cary, NC : Published by Oxford University Press on behalf of the Infectious Diseases Society of America, [2014]- |
| Abstract: | Background: There is limited knowledge on the extent of antimicrobial stewardship program (ASP) implementation in health care facilities (HCFs) in Latin America.; Methods: We performed an evaluation of ASPs in Latin American HCFs from March 2022 to February 2023 using a structured self-assessment survey associated with a scoring system that evaluated leadership support and accountability, resources, antibiotic stewardship actions, education, and antibiotic use (AU) monitoring and reporting. Additionally, we collected monthly AU data (antibiotic consumption and point prevalence surveys) and number of multidrug-resistant infections in medical-surgical intensive care units. Self-assessment scores were correlated with AU through multivariable regression models adjusting for bed size, country of HCF, and incidence of infections (when appropriate).; Results: Of the 39 HCFs recruited for the study, all completed the self-assessment, 36 performed the point prevalence survey, and 29 collected antibiotic consumption data. The overall median self-assessment score was 252.5 (IQR, 212.5-285) for a maximum possible score of 335. A high self-assessment score (top quartile) was associated with higher guideline-compliant AU (odds ratio [OR], 8.63; 95% CI, 3.03-24.6; P < .001), higher use of directed therapy (OR, 2.11; 95% CI, 1.41-3.1; P < .001), and less consumption of anti-methicillin-resistant Staphylococcus aureus agents (OR, -8.59; SE = 4.12; P = .037) after adjusting for bed size, country, and incidence of methicillin-resistant S aureus infections.; Conclusions: Higher-level ASP implementation in Latin American HCFs correlated with better compliance with AU guidelines and decreased the use of vancomycin in the intensive care unit, supporting the need to improve resources for ASPs.; (© The Author(s) 2025. Published by Oxford University Press on behalf of Infectious Diseases Society of America.) |
| Competing Interests: | Potential conflicts of interest. All authors: No reported conflicts. |
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| Contributed Indexing: | Keywords: Latin America; antibiotic use; implementation; resources; stewardship |
| Entry Date(s): | Date Created: 20250721 Latest Revision: 20250723 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC12272052 |
| DOI: | 10.1093/ofid/ofaf364 |
| PMID: | 40689250 |
| Database: | MEDLINE |
Journal Article