Purpose: Antimicrobial resistance (AMR) presents a significant threat to human health. The root cause for this global problem is irrational antimicrobial usage. Antimicrobial stewardship (AMS) emphasises on the appropriate use of antibiotics and ensures strict implementation of antimicrobial policy guidelines. This study was conducted to evaluate the impact of auditing of AMS programme on regulating the antimicrobial policy adherence and antimicrobial usage in hospital intensive care units. Materials and Methods: This was a prospective interventional study. It consisted of pre-implementation and implementation phases 6 months each. Two hundred and eighty patients were enrolled. Details of antibiotic consumption, surgical prophylaxis, culture/sensitivity patterns, de-escalation rates, etc., were collected in both phases. The implementation phase, in addition, included stewardship audit rounds. Results: In pre-implementation phase and implementation phases: policy adherence rates were 23.7% and 41.8%, respectively, de-escalation rates were 22.73% and 43.48%, respectively. Cultures were sent before the initiation of antimicrobials in 36.73% cases during the pre-implementation phase, which improved to 60.41% during the implementation phase. Defined daily dose (DDD) for the antibiotics was 98.66 DDD 100BD during the pre-implementation phase, which reduced to 91.62 DDD 100BD in the implementation phase. Total days of therapy (DOT) in the pre-implementation phase were 561 DOT1000BD, which reduced to 463 DOT1000BD during the implementation phase. Conclusions: Implementation of continuous monitoring of the AMS programme, therefore, has a definite role in reducing the antimicrobial consumption and improving the compliance to the policy guidelines. A more robust study for a prolonged period is, however, necessary to have a better analysis of the outcome.


中文翻译：

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抗菌药物管理计划对规范三级护理中心选定重症监护病房的政策遵守和抗菌药物使用的影响 - 一项前瞻性干预研究



目的：抗菌素耐药性（AMR）对人类健康构成重大威胁。这一全球性问题的根源在于抗菌药物的不合理使用。抗菌药物管理（AMS）强调抗生素的适当使用，并确保严格执行抗菌政策指南。本研究旨在评估 AMS 计划审核对规范医院重症监护病房抗菌政策遵守和抗菌药物使用的影响。材料和方法：这是一项前瞻性干预研究。它包括预实施和实施阶段，各阶段 6 个月。招募了 280 名患者。在两个阶段都收集了抗生素消耗、手术预防、培养/敏感性模式、降级率等详细信息。此外，实施阶段还包括多轮管理审计。结果：实施前阶段和实施阶段：政策执行率分别为23.7%和41.8%，降级率分别为22.73%和43.48%。在实施前阶段，有 36.73% 的病例在开始抗菌药物之前进行了培养，而在实施阶段，这一比例提高到 60.41%。实施前阶段抗生素的规定日剂量（DDD）为98.66 DDD 100BD，实施阶段减少至91.62 DDD 100BD。实施前阶段的总治疗天数 (DOT) 为 561 DOT1000BD，实施阶段减少至 463 DOT1000BD。 结论：因此，实施 AMS 计划的持续监测对于减少抗菌药物消耗和提高对政策指南的遵守具有明确的作用。然而，为了更好地分析结果，需要进行更长期的更稳健的研究。