{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T05:35:09Z","timestamp":1780378509028,"version":"3.54.1"},"reference-count":37,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T00:00:00Z","timestamp":1772496000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Background\/Objectives: Antimicrobial resistance (AMR) is a major global public health threat, particularly in hospitals. Antimicrobial Stewardship Programs (ASPs) aim to optimize prescribing, reduce unnecessary exposure to broad-spectrum agents, and mitigate resistance. This study evaluated the clinical, ecological, and economic impact of an ASP implemented in January 2021 in a high-complexity hospital in Brazil, focusing on antimicrobial consumption, temporal trends in bacterial susceptibility, and direct antimicrobial-related costs. Methods: A quasi-experimental pre\u2013post study using an interrupted time-series design was conducted in the adult intensive care unit from January 2019 to December 2023. Antimicrobial consumption was measured as Defined Daily Doses per 1000 patient-days (DDD\/1000-PD) for ceftriaxone, meropenem, piperacillin\u2013tazobactam, vancomycin, and polymyxin B. Temporal trends were assessed using Joinpoint regression, and pre- and post-intervention periods were compared using Student\u2019s or Mann\u2013Whitney tests. Susceptibility data were interpreted according to BrCAST standards. Results: Significant and sustained reductions were observed for all agents except polymyxin B. Susceptibility improved or stabilized among key Gram-negative pathogens, with a significant increase in aggregated Gram-negative susceptibility after 2021, while intrinsically resistant organisms showed limited change. Annual antimicrobial costs decreased by approximately USD 174,000. Conclusions: The ASP was associated with reduced broad-spectrum antimicrobial use, favorable ecological trends, and substantial cost savings.<\/jats:p>","DOI":"10.3390\/antibiotics15030264","type":"journal-article","created":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T12:48:56Z","timestamp":1772542136000},"page":"264","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Impact of an Antimicrobial Stewardship Program on Antibiotic Consumption, Bacterial Susceptibility, and Costs in a High-Complexity Public Hospital"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-2311-4302","authenticated-orcid":false,"given":"J\u00e9ssica Cristina Bilizario","family":"Noguerol Andrade","sequence":"first","affiliation":[{"name":"Doctoral Program, Pharmaceutical Sciences, University of Sorocaba, Sorocaba 18023-000, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatriz Souza","family":"Santos","sequence":"additional","affiliation":[{"name":"Doctoral Program, Pharmaceutical Sciences, University of Sorocaba, Sorocaba 18023-000, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7138-0376","authenticated-orcid":false,"given":"Fernando de S\u00e1","family":"Del Fiol","sequence":"additional","affiliation":[{"name":"Doctoral Program, Pharmaceutical Sciences, University of Sorocaba, Sorocaba 18023-000, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,3]]},"reference":[{"key":"ref_1","unstructured":"WHO (2025, November 05). 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