DEVELOPMENT AND IMPLEMENTATION OF AN ANTIMICROBIAL STEWARDSHIP PROGRAM THROUGH THE CONTROL OF ANTIMICROBIAL RESISTANCE AND THE RATIONAL USE OF ANTIBIOTICS

Abstract

Antimicrobial resistance is a serious threat to public health and patient safety globally, leading to increased medical costs, patient treatment failure, and increased mortality rates from infections. The objective is to slow down the development of resistance and maintain a balance between effective therapy and the inappropriate use of antibiotics, which contributes to resistance. An antimicrobial stewardship program is a coordinated effort to ensure that the use of antimicrobial drugs, such as antibiotics, is optimal in terms of effectiveness and safety, while minimizing the development of resistance. This evidence-based approach addresses the correct selection of antimicrobial agents, dosages, routes of administration, and duration of therapy. The antimicrobial stewardship program involves implementing strategies and guidelines for prescribing and using antimicrobials appropriately, monitoring their usage, and educating healthcare professionals and patients about their proper use. The goal is to promote responsible use of antimicrobials and prevent the emergence of antimicrobial-resistant infections. The significance of implementing an antimicrobial stewardship program in hospitals has been further highlighted by the COVID-19 pandemic.
For this purpose, a prospective study was conducted with the aim of analyzing the clinical results of the implemented program for antimicrobial management, by monitoring the trend of total antibiotic consumption, as well as monitoring the total number of approved justified/unjustified antibiotics from the intended control group: Meropenem, Imipenem/Cilastatin, Piperacillin/tazobactam, Colomycin, Moxifloxacin, Linezolid and Ertapenem, during the designated period before implementation (2021) and respectively after implementation (2022) of the program for antimicrobial management, in hospitalized patients at the Acibadem Sistina Clinical Hospital. After the implementation of the antimicrobial stewardship program, a decrease in the total consumption of the controlled group of antibiotics was observed, with the exception of linezolid. Moreover, there was a decline in the trend of unjustified approved antibiotics at the expense of an increase in justified approved antibiotics from the controlled group. To prevent antimicrobial resistance, a comprehensive early microbiological screening of patients was conducted, and a specific antibiotic regimen was chosen to reduce inappropriate empirical treatment. This monitoring enabled the tracking of the total number of pathogenic agents or isolates.
Continual monitoring of the AMS program's effectiveness and making necessary adjustments is essential to optimize its impact.