Retrospective Evaluation of an Antimicrobial Stewardship Program in a Tertiary Care Hospital: A Pharmacist’s Perspective
Abstract
Objective: This study aimed to evaluate the impact of antimicrobial stewardship (AMS) programs by analysing the dose appropriateness, antibiotic consumption, surgical prophylaxis compliance, drug selection, and de-escalation of antibiotic therapy based on culture and sensitivity reports.
Material and Methods: A retrospective evaluation of data from medical records and antibiotic consumption in the departments of medicine, surgery, paediatrics, and orthopaedics at a tertiary care hospital from November 2021 to February 2022 was conducted. Through coding, the data entered on the pre-designed proforma were converted into statistical variables.
Results: Total overall consumption, daily defined dose, of antibiotics decreased from 412.49 grams (g) to 391.60 g (p-value=0.540, confidence interval [CI]=-10.12–17.08). The percentage of antibiotics prescribed was reduced from 61% to 58%, the average duration of antibiotics per patient was reduced from 4.3 days to 3.7 days, and days of therapy was reduced from 399 to 302 (p-value≤0.001, CI=-465.57–353.24). The time compliance of surgical antibiotic prophylaxis was improved from 95.65% to 99.09% (p-value=0.063, CI=-5.256–0.256). Periodically updated, cumulative hospital antibiogram and antibiotic treatment guidelines were functional, culture and sensitivity-based dosage adjustments were practised in the facility.
Conclusion: A well-run AMS program helps hospitals in promoting compliance with antibiotic prescribing guidelines, preventing antimicrobial resistance by decreasing unnecessary antibiotic use.
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