జర్నల్ ఆఫ్ ఇన్ఫెక్షియస్ డిసీజెస్ అండ్ థెరపీ

నైరూప్య

Antimicrobial stewardship: A shared responsibility among primary prescribers, pharmacists, infectious disease physicians and microbiologists

Adila Shaukat, Walid Al-Wali, Eman Nawash, Hala Sonallah

ntroduction:
Antimicrobial stewardship is a key component of a multidisciplinary approach to prevent emergence of
antimicrobial resistance. It is an imperative to have antimicrobial stewardship program in place in each hospital and
health facility.
Method:
Antimicrobial stewardship (AMS) program in our hospital was initiated in 2017 and interventions introduced were
formulary restriction, preauthorization, education of health care workers, prospective data collection and feedback to
prescribers, IV to oral switch for eligible cases.
Results:
Discontinuation and de-escalation rate of restricted antimicrobials was cumulatively around 60% whereas only
35-40% of restricted antimicrobials were continued. Appropriateness of initiation of antimicrobial was improving over
time by regular/continuous education and increasing awareness to prescribers. We noticed a positive impact on
antimicrobial prescribing patterns as primary prescribers/pharmacists were actively reassessing the cases and deescalating
antimicrobials when indicated. There was a 50% decline in hospital associated Clostridium difficile cases
and slight downwards trend in MDROs.
Conclusion:
AMS program in our facility has demonstrated a downward trend in consumption of broad-spectrum
antimicrobials, increased IV to oral conversion rates for antimicrobials and decrease in hospital-acquired Clostridium
difficile infections. Antimicrobial stewardship is a shared responsibility among primary prescribers, pharmacists,
infectious disease physicians as well as microbiologists to ensure safe antimicrobial prescribing and improving
patient outcome.