Practice implications of an antimicrobial stewardship intervention in a tertiary care teaching hospital, Qatar

Abstract

Background: Antibiotic misuse is a worldwide public health problem and has been associated with increased morbidity, length of hospital stay, mortality, healthcare costs, and most importantly antibiotic resistance. Aims: We aimed to evaluate the compliance of antibiotic prescribing with national guidelines, assess how educational interventions can best be utilized to make impact and fill gaps for optimal antibiotic utilization, and to identify facilitators and barriers to implementing ASPs in Qatar. Methods: Six cross-sectional baseline audits of antibiotic prescribing were conducted over a two-week period at a tertiary care teaching hospital. A sub-analysis of prescriptions with follow up has followed. An educational intervention utilizing the PDSA (Plan-Do-Study-Act) tool was implemented to address gaps identified. A repeated audit was done to assess the impact of change. Lastly, interviews were conducted to recognize perceived facilitators and barriers for ASP implementation, identify strategies to overcome barriers, and evaluate the effectiveness of educational interventions. Results: The most common indication for antibiotic prescribing was febrile neutropenia (20.7%). The most frequently used class of antibiotics was carbapenems (21.4%). Sixty percent of prescriptions complied with guidelines. The rationale behind choosing not to adhere to guidelines was not documented in 37.2% of cases. Suboptimal documentation in records was targeted through our intervention. The audit post intervention showed slight improvement in documentation. Facilitators and barriers included: collaboration and communication among teams, compliance with guidelines, interventions documented by clinical pharmacists, and electronic system errors. Conclusions: Effective communication, continuous documentation in records, and repetitive education promote rational antibiotic prescribing and enhance ASPs.

Compliance with antibiotic prophylaxis guidelines in caesarean delivery: a retrospective, drug utilization study (indication-prescription type) at an Ecuadorian hospital

“…The participation of the pharmacist within the health care team translates into a decrease in unnecessary costs, an increase in the quality of care and an improvement in the patient's quality of life. These results have led to the acceptance of this professional by other members of the health team [36][37][38][39][40][41]. To date, there is no clinical pharmacist at the target institution involved in the design, implementation and review of therapeutic protocols, including PAP.…”

Compliance with antibiotic prophylaxis guidelines in caesarean delivery: a retrospective, drug utilization study (indication-prescription type) at an Ecuadorian hospital.

“…The participation of the pharmacist within the health care team translates into a decrease in unnecessary costs, an increase in the quality of care and an improvement in the patient's quality of life. These results have led to the acceptance of this professional by other members of the health team [36][37][38][39][40][41]. To date, there is no clinical pharmacist at the target institution involved in the design, implementation and review of therapeutic protocols, including PAP.…”

The Role of Electronic Medical Record in Enhancing Rational Antibiotics Prescription: A Systematic Review

“…The amount of prescription and duration of vancomycin and co-amoxiclav therapy decreased compared without the involvement of the 3 disciplines (Tiszai-Szucs et al, 2018). Nasr et al (2019) evaluate the administration of antibiotics in cancer patients who have infections with PDSA tools (Plan, Do, Study, Act), then conduct promotional education to multidisciplinary experts (doctors and pharmacists) about antibiotic management programs continuously and assesses problems experienced when do rational antibiotic therapy in patients.…”