Epistīmonika Chronika (Jan 2017)
Development of effective hospital-based antibiotic stewardship program. The role of infectious disease specialist
Abstract
Excessive antibiotic consumption and misuse is one of the main factors responsible for the emergence of antibiotic-resistant bacteria and has been associated with increased health care costs. Active intervention is necessary in changing antimicrobial prescribing practices. The Infection Control Committee and the administration of our hospital decided to implement an antibiotic stewardship program beginning in January 2016 in order to reduce inappropriate antibiotic use and to combat antibiotic resistance through improved prescribing practices. The antimicrobial stewardship team includes an ID specialist, physicians, infection control nurses, a microbiologist and a pharmacist who are responsible for the implementation of the program. Preauthorization by an ID specialist and prospective review is necessary for all pharmacy orders of antibiotics under restriction. Pre-intervention, we collected Pharmacy and hospital data regarding antibiotic consumption and numbers of patient-days for the years 2013-2015. We calculated antibiotic use in Defined Daily Doses (DDDs)/100 patient-days. After one year, the antibiotic stewardship program was effective in reducing consumption of most antibiotics. The result of the implementation of the program in our hospital was a reduction about 17% of antibiotic DDDs/100 patient-days and about 21% of the antibiotic cost/100 patient-days. Education is an essential element of our program in order to influence prescribing behavior. Lectures and brochures are used to supplement strategies. Antibiotic stewardship programs have been shown from many studies to improve patient outcomes, reduce antibiotic resistance and save money.
