Evaluation Of Antimicrobial Stewardship Programs Implementation And Outcomes In Selected Hospitals At Makkah Region, Kingdom Of Saudi Arabia
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Date
2018-01
Authors
., Abdul Haseeb
Journal Title
Journal ISSN
Volume Title
Publisher
Universiti Sains Malaysia
Abstract
Antimicrobial stewardship programs (ASPs) are collaborative efforts to
optimize antimicrobial use in healthcare institutions through evidence-based quality
improvement strategies. The aim of this research was to evaluate the impact of ASPs
in a critical care setting for improving antimicrobial use, cost efficiency and clinical
outcomes at selected hospitals in Makkah, Kingdom of Saudi Arabia (KSA). In phase
one study, an exploratory survey approach was adopted to determine the presence of
morbidity caused by organisms in both out and in-patients blood isolates at two Saudi
hospitals. Besides that, resistance pattern among community acquired pathogens such
as the Multi Drug Resistant Acinetobacter Baumannii (MDR-AB) was also
documented. The findings from this phase suggested that there was high incidence of
both gram positive and gram negative organisms in general wards over a 12 years
period. In the same phase, results of multiple logistic regression of risk factors
associated with Multidrug Resistant Acinetobacter baumanni (MDR-AB) were as
follows: immunosuppression (OR = 2.9; 95% CI 1.5-5.6; p = 0.002), clinical outcome
(OR = 0.4; 95% CI 0.3-0.9; p = 0.01), invasive procedure (OR = 7.9; 95% CI 1.8-34.2;
p = 0.002), central venous catheter use (OR = 2.9; 95% CI 1.5-5.6; p = 0.000), and
endotracheal tube use (OR = 3.4; 95% CI 1.6-7.3; p = 0.001). In the phase two study, a
survey to explore current success and issues related to implementation of ASP programs
in Makkah region hospitals at the pharmacy level (n = 23) and at the national level
among critical care physician (n=382) were carried out. Among responding hospitals,
respondents from 19 (76%) hospitals summarized ASP programs as following:
formulary restrictions (90%) for broad-spectrum antimicrobials and use of automatic
stop orders (65%) to limit empirical therapy of antimicrobials.
Description
Keywords
Evaluation of antimicrobial stewardship programs implementation , outcomes in selected hospitals at Makkah region