TY - JOUR
T1 - Impact of a multidisciplinary antimicrobial stewardship programme on piperacillin-tazobactam use at a Danish university hospital
T2 - A pre-post interventional study
AU - Holler, Jon Gitz
AU - Printzlau, Pernille
AU - Jensen, Tomas O
AU - Rezahosseini, Omid
AU - Kraef, Christian
AU - Harboe, Zitta Barrella
AU - Lindegaard, Birgitte
AU - Kolte, Lilian
AU - Pedersen, Thomas Ingemann
AU - Hansen, Dennis S
AU - Søborg, Christian
N1 - Copyright © 2026 The Author(s). Published by Elsevier Ltd.. All rights reserved.
PY - 2026/1/23
Y1 - 2026/1/23
N2 - BACKGROUND: Piperacillin-tazobactam (TZP) is widely used empirically in Danish hospitals despite guideline restrictions, making it an important target for antimicrobial stewardship (AMS).AIM: To evaluate the impact of a multidisciplinary antimicrobial stewardship (AMS) programme on TZP use, prescribing quality, and clinical safety outcomes at a Danish university hospital.METHODS: A prospective, quasi-experimental study using interrupted time series (ITS) and two hospital-wide point prevalence surveys (PPS, 2021 and 2023) was conducted from January 2022 to December 2024. The AMS programme, introduced in January 2023, included prospective audit and feedback, education, and monthly department-level reports. Days of therapy (DOT)/1,000 bed-days assessed antimicrobial trends. Logistic regression analysed guideline adherence and prescribing quality indicators; Poisson regression assessed changes in proportional DOT.RESULTS: Among 156,035 admissions, 92,346 (59.2%) occurred in AMS-implementing departments. TZP use decreased by 19.5% (95% CI: -25.5 to -13.5%; p<0.001) but increased by 26.7% in non-AMS departments (95% CI: 18.6 to 34.9%; p<0.001). Benzylpenicillin, ampicillin, and aminoglycoside use increased by 14.2%, 20.2%, and 36.4%, respectively, in AMS wards. PPS findings (n=262) showed improved guideline adherence (OR 2.32, 95% CI: 1.38-3.90), documentation of indication (OR 3.06), treatment planning (OR 9.83), and reassessment within 72 hours (OR 2.52). Thirty-day readmission decreased from 11.6% to 10.2% (p=0.0001), while in-hospital mortality remained unchanged (6.0% vs. 6.1%; p=0.962).CONCLUSION: A multidisciplinary AMS programme was associated with reduced TZP use and improved prescribing quality in participating departments without adverse effects on safety indicators. These findings support AMS as an effective strategy to optimise antibiotic use.
AB - BACKGROUND: Piperacillin-tazobactam (TZP) is widely used empirically in Danish hospitals despite guideline restrictions, making it an important target for antimicrobial stewardship (AMS).AIM: To evaluate the impact of a multidisciplinary antimicrobial stewardship (AMS) programme on TZP use, prescribing quality, and clinical safety outcomes at a Danish university hospital.METHODS: A prospective, quasi-experimental study using interrupted time series (ITS) and two hospital-wide point prevalence surveys (PPS, 2021 and 2023) was conducted from January 2022 to December 2024. The AMS programme, introduced in January 2023, included prospective audit and feedback, education, and monthly department-level reports. Days of therapy (DOT)/1,000 bed-days assessed antimicrobial trends. Logistic regression analysed guideline adherence and prescribing quality indicators; Poisson regression assessed changes in proportional DOT.RESULTS: Among 156,035 admissions, 92,346 (59.2%) occurred in AMS-implementing departments. TZP use decreased by 19.5% (95% CI: -25.5 to -13.5%; p<0.001) but increased by 26.7% in non-AMS departments (95% CI: 18.6 to 34.9%; p<0.001). Benzylpenicillin, ampicillin, and aminoglycoside use increased by 14.2%, 20.2%, and 36.4%, respectively, in AMS wards. PPS findings (n=262) showed improved guideline adherence (OR 2.32, 95% CI: 1.38-3.90), documentation of indication (OR 3.06), treatment planning (OR 9.83), and reassessment within 72 hours (OR 2.52). Thirty-day readmission decreased from 11.6% to 10.2% (p=0.0001), while in-hospital mortality remained unchanged (6.0% vs. 6.1%; p=0.962).CONCLUSION: A multidisciplinary AMS programme was associated with reduced TZP use and improved prescribing quality in participating departments without adverse effects on safety indicators. These findings support AMS as an effective strategy to optimise antibiotic use.
U2 - 10.1016/j.jhin.2025.12.014
DO - 10.1016/j.jhin.2025.12.014
M3 - Journal article
C2 - 41581607
SN - 0195-6701
JO - The Journal of hospital infection
JF - The Journal of hospital infection
ER -