Antibiotic Stewardship Program Experience in a Training and Research Hospital

Area of Science:

• Infectious Diseases
• Public Health
• Hospital Administration

Background:

• Antibiotic Stewardship Programs (ASP) are crucial for promoting rational antibiotic use.
• Turkey's early adoption of ASPs highlights a commitment to combating antimicrobial resistance.
• This study shares valuable insights from a hospital-based ASP implemented since 2013.

Purpose of the Study:

• To evaluate the impact of an established Antibiotic Stewardship Program (ASP) on antibiotic usage and prescribing practices.
• To share practical experiences and lessons learned from implementing ASP in a Turkish hospital setting.
• To assess the effectiveness of revised surgical prophylaxis guidelines and the integration of rapid diagnostic tests.

Main Methods:

• Adapted the Centers for Disease Control and Prevention's ASP checklist for hospital implementation.
• Revised surgical prophylaxis guidelines and monitored adherence through infection surveillance.
• Calculated antibiotic consumption indexes (ACI) and utilized rapid antigen detection tests (RADT) for upper respiratory tract infections.

Main Results:

• Surgical prophylaxis administration timing improved; third-generation cephalosporin use was restricted.
• Antibiotic consumption index (ACI) for class J01 in adult wards decreased from 80.5 to 64.8 DDD per 100 patient days (2014-2018).
• RADT use in pediatric patients with upper respiratory tract infections led to 75.1% being treated without antibiotics.

Conclusions:

• Motivated antimicrobial stewardship teams are essential in the current antimicrobial resistance era.
• Hospitals must establish and regularly revise their own tailored stewardship programs.
• Achieving rational antibiotic use necessitates a multidisciplinary approach and sustained effort.