AN ANTIBIOTIC STEWARDSHIP PROGRAM IN GENERAL SURGERY LEADS TO BETTER ANTIBIOTIC USE AND COST SAVINGS erica.secchettin@univr.it

 

AN ANTIBIOTIC STEWARDSHIP PROGRAM IN GENERAL SURGERY LEADS TO BETTER ANTIBIOTIC USE AND COST SAVINGS

8

 

 

 

 

Italy

Oral only

The World Health Organization (WHO) promotes judicious antibiotic use to address the antimicrobial resistance problem. Broad-spectrum antibiotics have been proposed for pancreatic surgery. This study evaluated the impact of a prospective antimicrobial stewardship program (ASP) on antibiotic consumption and cost savings before and after implementation in pancreatic surgery.

Data were collected from a single center participating in a multicenter ASP—the Pancreatic Surgery Unit at the University of Verona. The program focused on tailored antibiotic prophylaxis guided by preoperative rectal swab results. The study included only pancreatic surgeries, spanning two periods: pre-ASP (2015–2018) and post-ASP (2019–2022). Systemic antibiotic consumption was measured using the Anatomical Therapeutic Chemical classification (ATC-J01), defined daily doses (DDD), and normalized per 1000 patient-days (PDs). Trends in “Access” and “Watch” antibiotics (WHO classifications) and cost savings were analyzed and compared between periods.

ASP implementation was associated with a significant reduction in “Watch” antibiotic use (-2.89 DDD/1000 PDs; 95% CI [-5.55, -0.23], p=0.0341) and a nonsignificant increase in “Access” antibiotics (+3.48 DDD/1000 PDs; 95% CI [-4.93, 11.89], p=0.404). Monthly antibiotic costs decreased by €241.62 (p=0.523), resulting in total savings of €24,746.40. Cost reductions were primarily due to decreased “Watch” antibiotic use (€22,292.03), partly offset by increased “Access” antibiotic costs (€5,291.60).

An ASP in general surgery improves antibiotic prescribing by reducing “Watch” antibiotic use, supporting WHO guidance on appropriate antibiotic use. Beyond clinical benefits such as fewer surgical site infections and complications, ASPs may also yield substantial cost savings.