Antimicrobial Stewardship: An Evidence Based Based Approach
Keywords:
Antimicrobial stewardship, Antibiotic resistance, Healthcare-associated infections, Evidence-based medicine, Rational antibiotic useAbstract
Introduction: The global rise of antimicrobial resistance (AMR) poses a significant threat to public health, prompting the need for systematic approaches to optimize antibiotic use. Antimicrobial Stewardship Programs (ASPs) aim to enhance patient outcomes, reduce microbial resistance, and lower unnecessary healthcare costs by promoting appropriate antimicrobial usage.
Materials and Methods: This is a prospective and observational study was conducted across tertiary-care hospitals between January 2024 and December 2024. Data collection included antimicrobial prescriptions, resistance patterns, intervention outcomes, and adherence to ASP guidelines. Inclusion criteria were adult inpatients receiving antimicrobials; exclusion criteria included immunocompromised individuals and pediatric cases.
Results: There was a significant reduction in broad-spectrum antibiotic use, especially Meropenem from 36% to 20.7% and Piperacillin-tazobactam from 45.3% to 28%. There was a statistically significant decline in total antibiotic consumption, especially Carbapenems: −41.9%, Broad-spectrum β-lactams: −38.1% and Glycopeptides: −25%. Pathogens such as Klebsiella pneumoniae and E. coli showed reduced resistance to meropenem post-ASP implementation K. pneumoniae: from 42% to 28.7% and E. coli: from 30% to 21.3%.
Conclusion: Antimicrobial stewardship significantly improves antimicrobial use, reduces resistance, and optimizes clinical outcomes. Structured ASPs are essential in combating AMR and improving healthcare quality.
Downloads
Metrics
References
Laxminarayan R, et al. Antibiotic resistance—the need for global solutions. Lancet Infect Dis. 2013;13(12):1057–1098.
Barlam TF, et al. Implementing an antibiotic stewardship program. Clin Infect Dis. 2016;62(10):e51–e77.
Davey P, et al. Interventions to improve antibiotic prescribing practices. Cochrane Database Syst Rev. 2017;(2):CD003543.
Howard P, et al. An international cross-sectional survey of antimicrobial stewardship programmes in hospitals. J Antimicrob Chemother. 2015;70(4):1245–1255.
Pulcini C, et al. Developing core elements and checklist items for global hospital ASPs. JAC-Antimicrobial Resistance. 2019;1(1):dlz022.
Malani AN, et al. Impact of a stewardship intervention. Infect Control Hosp Epidemiol. 2013;34(4):423–430.
Dyar OJ, et al. European medical students’ knowledge of antibiotics. J Antimicrob Chemother. 2014;69(3):842–846.
Charani E, et al. Behavior change strategies in hospital antibiotic prescribing. Clin Infect Dis. 2011;53(7):651–662.
Dar OA, et al. Exploring the evidence base for national and regional policy interventions. Lancet. 2016;387(10015):285–295.
Dik JW, et al. A validated tool to assess antimicrobial stewardship. J Antimicrob Chemother. 2015;70(9):2551–2558.
Livorsi DJ, et al. Effectiveness of electronic ASP tools. Am J Infect Control. 2015;43(3):236–241.
Saleem Z, et al. Hospital antimicrobial stewardship strategies in LMICs. Infect Drug Resist. 2019;12:447–456.
Pogue JM, et al. Appropriate antimicrobial therapy reduces mortality. Clin Infect Dis. 2011;53(8):867–874.
Schuts EC, et al. Cost-effectiveness of antimicrobial stewardship. Lancet Infect Dis. 2016;16(7):847–857.
Tamma PD, et al. The use of rapid diagnostic tests in stewardship. Clin Infect Dis. 2013;57(4):552–558.
Ibrahim OM, et al. Effectiveness of antimicrobial stewardship. Am J Health Syst Pharm. 2018;75(13):982–990.
Pakyz AL, et al. Trends in antimicrobial stewardship implementation. Infect Control Hosp Epidemiol. 2014;35(4):437–442.
Sikkens JJ, et al. Audit and feedback in antimicrobial stewardship. Clin Infect Dis. 2017;65(4):566–575.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
Terms:
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
