An antibiotic stewardship program in a surgical ICU of a resource-limited country: financial impact with improved clinical outcomes

Antibiotic resistance (ABX-R) is alarming in lower/middle-income countries (LMICs). Nonadherence to antibiotic guidelines and inappropriate prescribing are significant contributing factors to ABX-R. This study determined the clinical and economic impacts of antibiotic stewardship program (ASP) in su...

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Bibliographic Details
Published in:Journal of pharmaceutical policy and practice 2020-10, Vol.13 (1), p.69-69, Article 69
Main Authors: Hussain, Kashif, Khan, Muhammad Faisal, Ambreen, Gul, Raza, Syed Shamim, Irfan, Seema, Habib, Kiren, Zafar, Hasnain
Format: Article
Language:English
Subjects:
Administrative support
Antibacterial agents
antibiotic resistance
antibiotic stewardship program
Antibiotics
Antimicrobial agents
Clinical outcomes
Comparative analysis
Cost analysis
Critical care
Data collection
Disease control
Drug dosages
Drug resistance
Drug stores
Feedback
Hospital patients
Hospitals
Industrialized nations
Infections
infectious disease pharmacist
Infectious diseases
Information technology services
Intensive care
Intervention
Metronidazole
Microbial drug resistance
Mortality
Optimization
Pakistan
Patient outcomes
Patients
Pharmacists
Physicians
Prescription writing
Prescriptions
Sepsis
surgical-icu
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Summary:Antibiotic resistance (ABX-R) is alarming in lower/middle-income countries (LMICs). Nonadherence to antibiotic guidelines and inappropriate prescribing are significant contributing factors to ABX-R. This study determined the clinical and economic impacts of antibiotic stewardship program (ASP) in surgical intensive care units (SICU) of LMIC. We conducted this pre and post-test analysis in adult SICU of Aga Khan University Hospital, Pakistan, and compared pre-ASP (September-December 2017) and post-ASP data (April-July 2018). January-March 2018 as an implementation/training phase, for designing standard operating procedures and training the team. We enrolled all the patients admitted to adult SICU and prescribed any antibiotic. ASP-team daily reviewed antibiotics prescription for its appropriateness. Through prospective-audit and feedback-mechanism changes were made and recorded. Outcome measures included antibiotic defined daily dose (DDDs)/1000 patient-days, prescription appropriateness, antibiotic duration, readmission, mortality, and cost-effectiveness. 123 and 125 patients were enrolled in pre-ASP and post-ASP periods. DDDs/1000 patient-days of all the antibiotics reduced in the post-ASP period, ceftriaxone, cefazolin, metronidazole, piperacillin/tazobactam, and vancomycin showed statistically significant (  
ISSN:2052-3211
2052-3211
DOI:10.1186/s40545-020-00272-w