Antibiotic stewardship in a tertiary care hospital of a developing country: establishment of a system and its application in a unit—GASP Initiative

Antibiotic stewardship in a tertiary care hospital of a developing country: establishment of a system and its application in a unit—GASP Initiative

Purpose Despite the proven benefits of antimicrobial stewardship, models for executing the same in the developing countries are sparse. The present study highlights the approaches undertaken by our group in initiating one such program in a public sector tertiary level health care setting of a develo...

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Published in:Infection Vol. 44; no. 5; pp. 651 - 659
Main Authors: Shafiq, N., Praveen Kumar, M., Gautam, V., Negi, H., Roat, R., Malhotra, S., Ray, P., Agarwal, R., Bhalla, A., Sharma, N., Singh, R., Sharma, G. D., Bahadur, L., Yadanapudi, N., Gupta, R., Singh, G.
Format: Journal Article
Language:English
Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-10-2016
Springer Nature B.V
Subjects:
Anti-Infective Agents - therapeutic use
Antimicrobial agents
Developing Countries
Drug Utilization - statistics & numerical data
Drug Utilization Review - methods
Family Medicine
General Practice
Hospitals, Public
Humans
India
Infectious Diseases
Internal Medicine
LDCs
Medicine
Medicine & Public Health
Models, Theoretical
Original Paper
Prospective Studies
Public sector
Tertiary Care Centers
Defined daily dose
Electronic record
Antibiotic stewardship
System
Tertiary care
Developing country
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Summary:Purpose Despite the proven benefits of antimicrobial stewardship, models for executing the same in the developing countries are sparse. The present study highlights the approaches undertaken by our group in initiating one such program in a public sector tertiary level health care setting of a developing country. Methods The study focussed on development of a system after evaluation of existing issues and case study of implementation of the program in a unit within the hospital. The system building exercise included (1) development of generic data capture form for prospective audit and feedback; (2) development of an electronic system for data capture; (3) identification of key intervention points for strategy decision for stewardship in a particular unit; (4) application of the stewardship method and (5) evaluation of outcomes. Results A digital system for prospective audit was constructed after a background study. In the study unit, there was a significant decline in double anaerobic coverage. There was a significant decline in the average number of antimicrobials used per patients and a decrease in Defined Daily Dose of designated antimicrobials was noted. Additionally, there was an increase in the use of optimized doses. Conclusion A system for undertaking antimicrobial stewardship with a mechanism for prospective audit was put in place. The system may be adopted by other public sector hospitals of the developing country.
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ISSN:0300-8126
1439-0973
DOI:10.1007/s15010-016-0913-z