The impact of hospital-specific guidelines on carbapenem use and patient outcomes in a setting for high endemicity with multidrug-resistant gram-negative bacilli

Abstract

Objective: This study aims to assess the impact of hospital-specific guidelines on the optimal utilization of carbapenems and to examine their effects on patient outcomes. Design: Quasi-experimental study. Setting: Tertiary care hospital in Turkey where infectious diseases (IDs) consultation and antibiotic approval are mandatory for carbapenem use. Participants: All inpatients ≥18 years of age who received a carbapenem for at least 24 hours during the study periods were enrolled. Intervention: Hospital-specific treatment guidelines were introduced in April 2019. The control group was the year 2018, when there were no guidelines (pre-GP). The year 2020 was analyzed as the intervention period (post-GP). Results: A total of 678 patients were analyzed, 326 in the pre-GP period and 352 in the post-GP period. Following guideline implementation, there was a significant increase in appropriate carbapenem use (49.1% in pre-GP vs 71.9% in post-GP, P