Snapshot of antimicrobial stewardship programs in the hospitals of Pakistan: findings and implications

Saleem, Zikria, Hassali, Mohamed Azmi, Hashmi, Furqan Khurshid, Godman, Brian ORCID: 0000-0001-6539-6972 and Ahmed, Zakkiudin
(2019) Snapshot of antimicrobial stewardship programs in the hospitals of Pakistan: findings and implications. HELIYON, 5 (7). e02159-.

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<h4>Objective</h4>We are unaware of the extent of antimicrobial stewardship programs (ASPs) among hospitals in Pakistan, which is a concern given the population size, high use of antibiotics across sectors and increasing antimicrobial resistance (AMR) rates. Consequently, we sought to address this by undertaking a comprehensive survey.<h4>Method</h4>In this cross-sectional observational study in Punjab, an instrument of the measure was developed based on health care facility characteristics and ASPs after an extensive literature review<b>.</b> The questionnaire was circulated by mail or through drop off surveys to medical superintendents or directors/heads of pharmacy departments of hospitals.<h4>Results</h4>Out of 254, a total of 137 hospitals fully completed the questionnaire - 11 primary, 65 secondary, 46 tertiary and 15 specialized hospitals. The use of antimicrobial prescribing guidelines (68.7%), provision of infectious diseases consultation services (66.4%), clinical pharmacy service (65.7%), use of drug and therapeutics committees to approve antimicrobial prescribing (65.5%), regular audit by doctors on antimicrobial prescribing (54.1%) and use of a restricted formulary for antimicrobial (50.4%) were the most common ASPs. However, most of these activities were only somewhat or moderately successful. Whereas, electronic antimicrobial prescribing approval systems (15.3%), using a sticker to notify prescribers regarding the need to obtain approval for the antimicrobial prescribed (16.1%) and participation in the national antimicrobial utilization surveillance program (19.7%) were only seen in a few hospitals.<h4>Conclusion</h4>Study inferred that there are inadequate ASPs in the hospitals of Pakistan. A multidisciplinary approach, clinical leadership and availability of motivated and trained individuals are essential elements for the success of future ASPs.

Item Type: Article
Uncontrolled Keywords: Epidemiology, Infectious disease, Microbiology, Public health, Antimicrobial stewardship, Antimicrobial resistance, Pakistan
Depositing User: Symplectic Admin
Date Deposited: 05 Aug 2019 10:35
Last Modified: 19 Jan 2023 00:36
DOI: 10.1016/j.heliyon.2019.e02159
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