Clinical and Economic Impact of Antimicrobial Stewardship Interventions Reported Among Hospital Inpatients in The Middle East: a Systematic Review Protocol

Abstract

Antimicrobial Resistance (AMR) is a major global concern, negatively impacting public health outcomes (1-5), patient safety (3,6-8) and poses enormous burden on economic development and security (8-16). Internationally, data suggests, at any given time, approximately one-third of the hospitalized patients and over two-thirds of critically ill patients are prescribed antimicrobials and more than half of these prescribed antimicrobials are deemed inappropriate (5,17,18).

A questionnaire based survey among pharmacy practitioners to evaluate the level of knowledge and confidence towards antimicrobial stewardship

“…20,30 In our sample (n=88) 52% (n=46) of practitioners had an experience in AMS rotations, which is a close result to a study that was done on Australian healthcare professionals where 48% of them reported working in a facility that has an AMS Program. 23 In other studies, done in the Middle East, there was awareness among the healthcare professionals and pharmacists, 30,31 but the limited resources were the major challenge to limiting the students and the pharmacists to undergo training related to AMS and be exposed to an ASP team. 32,33 In another study the high assumption of their knowledge is a result of the high level of confidence that they have due to their experience in antimicrobial stewardship rotations and the training they received (p-value <0.001).…”

“…27 The Infectious Disease Society of America (IDSA) defined ASP as "a set of coordinated interventions designed to improve antimicrobial use in terms of selecting the appropriate agent, dose, route of administration, and therapy duration without compromising patient outcomes". 30,31 The literature showed that receiving successful training gives the the clerk or trainee the opportunity to be exposed to the clinical environment along with benefiting from the existing structure. 20,30 In our sample (n=88) 52% (n=46) of practitioners had an experience in AMS rotations, which is a close result to a study that was done on Australian healthcare professionals where 48% of them reported working in a facility that has an AMS Program.…”

“…30,31 The literature showed that receiving successful training gives the the clerk or trainee the opportunity to be exposed to the clinical environment along with benefiting from the existing structure. 20,30 In our sample (n=88) 52% (n=46) of practitioners had an experience in AMS rotations, which is a close result to a study that was done on Australian healthcare professionals where 48% of them reported working in a facility that has an AMS Program. 23 In other studies, done in the Middle East, there was awareness among the healthcare professionals and pharmacists, 30,31 but the limited resources were the major challenge to limiting the students and the pharmacists to undergo training related to AMS and be exposed to an ASP team.…”

“…It also threatens the achievements of modern medicine, 1 as it makes the treatment of severe infectious diseases efficiently and appropriately a significant challenge, knowing that the development of new antimicrobials is currently rare. 1,2 This creates a major burden on health care systems around the globe. 3 The spread of the AMR issue that is occurring worldwide has resulted ine developed countries reporting high levels of resistant organisms.…”

A systematic review of Antimicrobial Stewardship Program implementation in Middle Eastern countries

“…Antimicrobial stewardship has been adopted by healthcare systems worldwide as a pivotal approach to fighting antimicrobial resistance (Thomas et al, 2020). Our systematic review described the current published practices of antimicrobial stewardship programs in the Middle East region, and included 20 studies.…”