[Antimicrobial Stewardship programs in Peru: A fundamental agreement]

Area of Science:

• Infectious Diseases
• Public Health
• Hospital Administration

Background:

• Antimicrobial resistance (AMR) poses a significant global health challenge.
• Antibiotic stewardship programs (ASPs) are crucial for optimizing antimicrobial use and controlling AMR.

Purpose of the Study:

• To assess the diagnostic phase and early implementation of ASPs in three high-complexity Peruvian public hospitals.
• To evaluate the impact of ASP implementation on hospital resources and antimicrobial consumption patterns.

Main Methods:

• A quasi-experimental, multicenter study design was employed.
• Evaluated AMSP development, baseline microbiology, antimicrobial consumption, and consensus on stewardship activities.
• Data collected during diagnostic and early implementation phases.

Main Results:

• Hospitals significantly increased ASP resources and processes (score from 6.75 to 13.75).
• High prevalence of resistant bacteria noted: 50-60% ESBL-producing enterobacteria and 69% carbapenem-resistant Pseudomonas aeruginosa.
• Average defined daily doses (DDD) were 13.63 for ceftriaxone, 7.35 for vancomycin, and 6.73 for meropenem.
• Two hospitals achieved 30-50% reduction in overall antimicrobial use.

Conclusions:

• Successful ASP implementation was achieved through multidisciplinary teams and tailored strategies.
• Early-stage implementation led to a reduction in broad-spectrum antimicrobial consumption.
• ASPs are effective in improving stewardship and combating AMR in resource-limited settings.