Impact of the 2020 EUCAST « I » definition on the treatment of Pseudomonas aeruginosa infections: a national multicentric observational study in Belgian hospitals
AIM: To examine the impact of revisions by the European Committee on Antimicrobial Susceptibility Testing (EUCAST) on antibiotic selection for treating Pseudomonas aeruginosa infections in Belgian hospitals. BACKGROUND: In 2020, EUCAST redefined the 'I' category in antimicrobial susceptibi...
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| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2024-12-01
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| Series: | Journal of Global Antimicrobial Resistance |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213716524002522 |
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| Summary: | AIM: To examine the impact of revisions by the European Committee on Antimicrobial Susceptibility Testing (EUCAST) on antibiotic selection for treating Pseudomonas aeruginosa infections in Belgian hospitals. BACKGROUND: In 2020, EUCAST redefined the 'I' category in antimicrobial susceptibility testing to 'susceptible, increased exposure,' aiming to optimize antibiotic therapy by advocating targeted narrow-spectrum antibiotics at higher doses, rather than broader spectrum antibiotics at standard doses. By July 2022, Belgian labs were encouraged to adopt these changes, categorizing most antipseudomonal drugs as 'I' while retaining broad-spectrum antibiotics as 'S'. METHODS: Between November 2023 and May 2024, all Belgian hospitals were invited to participate in a voluntary multicentric retrospective observational study. Data were collected using a Redcap tool, focusing on hospitalized adults treated for wild-type Pseudomonas aeruginosa infections during a six-month period pre- and post-implementation of the new EUCAST definitions. Collected data included epidemiological, microbiological, clinical, and antimicrobial therapy details. The primary outcome assessed was the frequency of meropenem prescriptions following susceptibility testing. RESULTS: The study included 1705 patients (850 pre- and 855 post-implementation) from 38 hospitals (37% nationwide participation). Meropenem prescription significantly increased post-EUCAST update, rising from 4.6% (39/850) pre-implementation to 7.1% (61/855) post-implementation. This increase was observed in 47% (18/38) of the participating hospitals. CONCLUSIONS: The 2020 EUCAST criteria implementation led to a significant increase in meropenem prescriptions for P. aeruginosa infections. This underscores the need for further research into prescribing practices and reinforces the importance of prescriber education and antibiotic stewardship programs. |
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| ISSN: | 2213-7165 |