Short summary

Resistant bacteria is one of the greatest threats to human health. Region of Southern Denmark has therefore launched an antibiotic stewardship to improve the appropriate use of antibiotics and preventing antibiotic resistance. This study will evaluate how a regional antibiotic stewardship impacts the individual patient related antibiotic in-hospital prescriptions. 

It is a historical prospective cohort study of all acute admissions to hospitals in Region of Southern Denmark before and after the implementation.

Rationale

A worrying increase in antibiotic consumption and resistance has been described  in Denmark as well as globally. According to WHO, the problem of resistant bacteria is one of the greatest threats to human health and it is of prime importance that the use of antibiotics is restricted, as loss of efficacy in these drugs  will have a significant impact on humans with life-threatening infections. 

Antibiotic stewardship has been recommended as a method of improving appropriate use of antibiotics, preventing antibiotic resistance. As the first region in Denmark and most other countries, the Region of Southern Denmark has launched an antibiotic stewardship which covers an entire region. 

The aim of this study is to evaluate how a regional antibiotic stewardship impacts the individual patient related antibiotic in-hospital prescriptions. I) How many acutely admitted patients receive adequate antibiotic treatment on day 0 and day 2 - and does the implementation of an antibiotic stewardship change this? II) How is the onset, frequency, and duration of antibiotic treatment associated to the clinical cause and outcome of illness? III) How is the implementation of antibiotic stewardship associated to patient safety?

Description of the cohort

The study will include all acute admissions of adults in Southern Denmark between January 1st 2016 to Marts 20th 2018

Data and biological material

Register data is collected. The medical records are screened electronically for the prescribing and dispensing of antibiotics, and the type, dose and dates of treatment are identified. This information is linked to biochemistry, microbial and image diagnostics in relation to acute care, main symptoms and vital signs at arrival. In addition, the information is supplemented with information from the Danish National Patient Registry, the Danish Civil Registration System and the Odense Pharmacoepidemiological database.

Collaborating researchers and departments

Department of Emergency Medicine, Hospital of Southern Denmark, Aabenraa and Danish Institute of Regional Health Research, University of Southern Denmark, Aabenraa

• Associate professor Christian Backer Mogensen
• Post doc Helene Skjøt-Arkil

Department of Clinical Microbiology, Odense University Hospital

• Flemming Rosenvinge

Department of Infectious Diseases, Odense University Hospital

• Professor Isik Johansen

Center for Clinical Epidemiology, Odense University Hospital

• Associate professor Kim Oren Gradel
• Bjarne Magnussen
• Olav Sivertsen Garvik

Department of Clinical Microbiology, Hospital of Southern Denmark, Sønderborg

• Associate professor Ming Chen