Impact of the PROVAUR stewardship programme on linezolid resistance in a tertiary university hospital: a before-and-after interventional study

Abstract

Background There is little evidence of the impact of antimicrobial stewardship programmes on antimicrobial resistance.

Objectives To study the efficacy and safety of a package of educational and interventional measures to optimize linezolid use and its impact on bacterial resistance.

Methods A quasi-experimental study was designed and carried out before and after implementation of a stewardship programme in hospitalized patients with Gram-positive infections treated with linezolid.

Results The intervention reduced linezolid consumption by 76%. The risk of linezolid-resistant CoNS isolates (OR = 0.37; 95% CI = 0.27–0.49; P < 0.001) and Enterococcus faecalis (OR = 0.44; 95% CI = 0.21–0.90; P = 0.03) during the intervention period was lower than in the pre-intervention period.

Conclusions A programme to optimize linezolid use can contribute to reducing the resistance rate of CoNS and E. faecalis to this antibiotic.