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Yamba K, Chizimu JY, Mudenda S, Lukwesa C, Chanda R, Nakazwe R, Simunyola B, Shawa M, Kalungia AC, Chanda D, Mateele T, Thapa J, Kapolowe K, Mazaba ML, Mpundu M, Masaninga F, Azam K, Nakajima C, Suzuki Y, Bakyaita NN, Wesangula E, Matu M, Chilengi R. Assessment of antimicrobial resistance laboratory-based surveillance capacity of hospitals in Zambia: findings and implications for system strengthening. J Hosp Infect 2024; 148:129-137. [PMID: 38621513 PMCID: PMC11171463 DOI: 10.1016/j.jhin.2024.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 03/14/2024] [Accepted: 03/19/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND A well-established antimicrobial resistance (AMR) laboratory-based surveillance (LBS) is of utmost importance in a country like Zambia which bears a significant proportion of the world's communicable disease burden. This study assessed the capacity of laboratories in selected hospitals to conduct AMR surveillance in Zambia. METHODS This cross-sectional exploratory study was conducted among eight purposively selected hospitals in Zambia between August 2023 and December 2023. Data were collected using the self-scoring Laboratory Assessment of Antibiotic Resistance Testing Capacity (LAARC) tool. FINDINGS Of the assessed facilities, none had full capacity to conduct AMR surveillance with varying capacities ranging from moderate (63% (5/8)) to low (38% (3/8)). Some of the barriers of AMR-LBS were the lack of an electronic laboratory information system (63% (5/8)) and the lack of locally generated antibiograms (75% (6/8)). Quality control for antimicrobial susceptibility testing (AST), pathogen identification and media preparation had the lowest overall score among all of the facilities with a score of 14%, 20% and 44%, respectively. The highest overall scores were in specimen processing (79%), data management (78%), specimen collection, transport and management (71%), and safety (70%). Most facilities had standard operating procedures in place but lacked specimen-specific standard operating procedures. CONCLUSION The absence of laboratories with full capacity to conduct AMR surveillance hinders efforts to combat AMR and further complicates the treatment outcomes of infectious diseases. Establishing and strengthening LBS systems are essential in quantifying the burden of AMR and supporting the development of local antibiograms and treatment guidelines.
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Affiliation(s)
- K Yamba
- Antimicrobial Resistance Coordinating Committee Unit, Zambia National Public Health Institute, Lusaka, Zambia
| | - J Y Chizimu
- Antimicrobial Resistance Coordinating Committee Unit, Zambia National Public Health Institute, Lusaka, Zambia.
| | - S Mudenda
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia
| | - C Lukwesa
- Department of Health, Lusaka District Health Office, Lusaka, Zambia
| | - R Chanda
- Department of Pathology and Microbiology, University Teaching Hospitals, Lusaka, Zambia
| | - R Nakazwe
- Department of Pathology and Microbiology, University Teaching Hospitals, Lusaka, Zambia
| | - B Simunyola
- Department of Pharmacy, Ministry of Health, Lusaka, Zambia
| | - M Shawa
- Hokudai Center for Zoonosis Control in Zambia, Hokkaido University International Institute for Zoonosis Control, Lusaka, Zambia
| | - A C Kalungia
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia
| | - D Chanda
- Department of Internal Medicine, University Teaching Hospitals, Lusaka, Zambia
| | - T Mateele
- Department of Internal Medicine, Levy Mwanawasa University Teaching Hospital, Lusaka, Zambia
| | - J Thapa
- Division of Bioresources, Hokkaido University International Institute for Zoonosis Control, Sapporo, Hokkaido, Japan
| | - K Kapolowe
- Department of Internal Medicine, University Teaching Hospitals, Lusaka, Zambia
| | - M L Mazaba
- Antimicrobial Resistance Coordinating Committee Unit, Zambia National Public Health Institute, Lusaka, Zambia
| | - M Mpundu
- Action on Antibiotic Resistance (ReAct) Africa, Lusaka, Zambia
| | - F Masaninga
- Department of Health, World Health Organization, Lusaka, Zambia
| | - K Azam
- Strengthening Pandemic Preparedness, Eastern and Southern Africa Health Community, Arusha, Tanzania
| | - C Nakajima
- Division of Bioresources, Hokkaido University International Institute for Zoonosis Control, Sapporo, Hokkaido, Japan; International Collaboration Unit, Hokkaido University International Institute for Zoonosis Control, Sapporo, Hokkaido, Japan; Division of Research Support, Hokkaido University Institute for Vaccine Research and Development, Sapporo, Hokkaido, Japan
| | - Y Suzuki
- Division of Bioresources, Hokkaido University International Institute for Zoonosis Control, Sapporo, Hokkaido, Japan; International Collaboration Unit, Hokkaido University International Institute for Zoonosis Control, Sapporo, Hokkaido, Japan; Division of Research Support, Hokkaido University Institute for Vaccine Research and Development, Sapporo, Hokkaido, Japan
| | - N N Bakyaita
- Department of Health, World Health Organization, Lusaka, Zambia
| | - E Wesangula
- Strengthening Pandemic Preparedness, Eastern and Southern Africa Health Community, Arusha, Tanzania
| | - M Matu
- Strengthening Pandemic Preparedness, Eastern and Southern Africa Health Community, Arusha, Tanzania
| | - R Chilengi
- Antimicrobial Resistance Coordinating Committee Unit, Zambia National Public Health Institute, Lusaka, Zambia
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Jarab AS, Al-Alawneh TO, Alshogran OY, Heshmeh SA, Mukattash TL, Naser YA, Alefishat E. Knowledge and attitude of healthcare prescribers and pharmacists toward antimicrobial stewardship program and the barriers for its implementation. Antimicrob Resist Infect Control 2024; 13:35. [PMID: 38566242 PMCID: PMC10985862 DOI: 10.1186/s13756-024-01382-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 02/10/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Antimicrobial stewardship (ASP) is considered a key prevention strategy in addressing the worldwide concern of accelerating antimicrobial resistance. Limited research is available regarding healthcare providers' knowledge and attitude toward antimicrobial stewardship and the barriers for its implementation. METHODS The present cross-sectional study was conducted on pharmacists and healthcare prescribers (HCPs) in different hospital sites across Jordan. A validated survey was used to evaluate HCPs and pharmacists' knowledge, and attitudes towards ASP and the barriers for its implementation. Logistic and linear regression were conducted to identify the factors associated with knowledge and attitude toward ASP, respectively. RESULTS A total of 603 participants, 69 (11.4%) pharmacists and 534 (88.6%) HCPs completed the study questionnaire, with a response rate of 80.4%. The overall mean knowledge about ASP was 7.16 out of 10, ranging from 0 to 10 (SD 2.22). Being a pharmacist and increased awareness/familiarity about ASP were associated with improved ASP knowledge. The overall average attitude score was = 3.8 ± 0.49 (range: 1.8-4.8). Results revealed that being a pharmacist and improved knowledge were associated with improved attitude toward ASP. Lack of specialized staff with expertise in ASP and lack of access to education and training programs were the major barriers hinder ASP implementation. CONCLUSION Despite the reasonable knowledge and the positive attitude toward the ASP, several barriers were reported, particularly by the pharmacists. Therefore, promoting the presence of adequately skilled healthcare personnel, creating easily accessible online courses, and establishing a comprehensive database of ASP resources are all suggested approaches to improve the application of ASP in healthcare settings.
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Affiliation(s)
- Anan S Jarab
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, 22110, Irbid, P.O. Box 3030, Jordan
- College of Pharmacy, AL Ain University, Abu Dhabi, United Arab Emirates
| | - Tasneem O Al-Alawneh
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, 22110, Irbid, P.O. Box 3030, Jordan
| | - Osama Y Alshogran
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, 22110, Irbid, P.O. Box 3030, Jordan
| | - Shrouq Abu Heshmeh
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, 22110, Irbid, P.O. Box 3030, Jordan
| | - Tareq L Mukattash
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, 22110, Irbid, P.O. Box 3030, Jordan
| | - Yara A Naser
- School of Pharmacy, Medical Biology Centre, Queen's University Belfast, Northern Ireland, 97 Lisburn Road, BT9 7BL, Belfast, UK
| | - Eman Alefishat
- Department of Medical Sciences, College of Medicine and Health Science, Khalifa University of Science and Technology, 127788, Abu Dhabi, United Arab Emirates.
- Department of Biopharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, The University of Jordan, 11942, Amman, Jordan.
- Center for Biotechnology, Khalifa University of Science and Technology, 127788, Abu Dhabi, United Arab Emirates.
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Alqahtani NS, Bilal MM, Al Margan AM, Albaghrah FA, Al Sharyan AM, Alyami ASM. Assessment of Physicians' Practice in Implementing Antibiotic Stewardship Program in Najran City, Saudi Arabia: A Cross-Sectional Study. PHARMACY 2024; 12:24. [PMID: 38392931 PMCID: PMC10892749 DOI: 10.3390/pharmacy12010024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 01/20/2024] [Accepted: 01/23/2024] [Indexed: 02/25/2024] Open
Abstract
INTRODUCTION One of the main causes of illness, mortality, and rising medical costs is antimicrobial resistance, which is a global healthcare concern. OBJECTIVES This study explores the practice of physicians toward the effective implementation of Antibiotic Stewardship Programs (ASPs) in Najran city, Saudi Arabia. METHODOLOGY This cross-sectional study was conducted among physicians working at primary care setting in Najran city, Saudi Arabia, between May and August 2023. A self-administered questionnaire was distributed among the physicians composed of three parts: socio-demographic data, a questionnaire about physicians' practice in the efficacy of ASP, and a questionnaire about physicians' practice regarding prescribing antibiotics. RESULTS Of the 128 physicians who participated in the study, 60.2% were males, and 43.8% were aged between 36 and 45 years. Among the practices in implementing the ASP effectively, controlling the source of infection domain received the highest score (mean score: 4.83). Every practice domain mean score was greater than 3, indicating that study participants possessed a moderate level of ASP practice and implementation skills. The overall mean practice score in the effective implementation of ASP was 154.9 ± 25.5 out of 185 points, with good, moderate, and poor practices constituting 67.2%, 28.1%, and 4.7%, respectively. CONCLUSIONS The physicians showed a moderate level of practice for the effective implementation of ASPs in Najran city. The factors significantly associated with increased practice score include older age, male gender, Saudi nationality, handling five or fewer infection cases daily, and infection-initiated antibiotic prescribing treatment managed per day. These findings suggest the need for targeted interventions and educational programs to enhance physicians' adherence to ASP guidelines and promote appropriate antibiotic prescribing practices, ultimately contributing to global efforts in combating antimicrobial resistance and improving patient outcomes.
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Affiliation(s)
- Nasser Saeed Alqahtani
- Department of Family and Community Medicine, College of Medicine, Najran University, Najran 66462, Saudi Arabia
| | - Maha Mohammed Bilal
- Department of Family and Community Medicine, College of Medicine, Najran University, Najran 66462, Saudi Arabia
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Afzal S, Khan FU, Aqeel MT, Ullah M, Bajwa M, Akhtar M, Majid M. Impact of a pharmacist-led educational intervention on knowledge, attitude, and practice toward the rational use of antibiotics among healthcare workers in a secondary care hospital in Punjab, Pakistan. Front Pharmacol 2024; 14:1327576. [PMID: 38348350 PMCID: PMC10859775 DOI: 10.3389/fphar.2023.1327576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 12/28/2023] [Indexed: 02/15/2024] Open
Abstract
Introduction: Growing antimicrobial resistance (AMR) and decreasing efficacy of the available antimicrobials have become a significant public health concern. The antimicrobial stewardship program (ASP) ensures the appropriate use of antimicrobials and mitigates resistance prevalence through various interventions. One of the core components of the ASP is to educate healthcare workers (HWs). Therefore, this study aims to identify the impact of a pharmacist-led educational intervention targeting knowledge, attitude, and practices regarding rational antibiotic use among healthcare professionals in a secondary care hospital in Punjab. Methods: This is a single-center, questionnaire-based, pre-post interventional study conducted over a six-month time period. Data analysis was conducted using SPSS version 26. Results: Regarding the pre-interventional knowledge, attitude, and practice (KAP) score of the respondents, 90.3% had a good knowledge score, 81.5% had a positive attitude, and 72.3% of HWs (excluding doctors) had a good practice score. Additionally, 74.6% of the doctors had a good practice score. After educational intervention, there was a significant improvement in the knowledge, attitude, and practice of the respondent HWs (p-value <0.001). Furthermore, males have higher knowledge scores compared to females in the pre- and post-intervention stages (p-value <0.05), and doctors differ from nurses regarding knowledge scores in both pre- and post-intervention stages. Conclusion: Considering educational programs as the backbone of the ASP, it is imperative to sustain efforts in the ongoing educational programs of HWs to foster high awareness and adherence to the ASP among HWs.
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Affiliation(s)
- Shairyar Afzal
- Faculty of Pharmacy, Hamdard University, Islamabad, Pakistan
- Department of Pharmacy, District Head Quarter Hospital Jhelum, Jhelum, Pakistan
| | - Farman Ullah Khan
- Faculty of Pharmacy, Hamdard University, Islamabad, Pakistan
- Pharmacy Administration and Clinical Pharmacy Xian Jiaotong University, Xi’an, China
| | | | - Matti Ullah
- Faculty of Pharmacy, Hamdard University, Islamabad, Pakistan
| | - Mishal Bajwa
- Department of Pharmacy, Quaid-i-Azam University, Islamabad, Pakistan
| | - Masoom Akhtar
- Faculty of Pharmacy, Hamdard University, Islamabad, Pakistan
| | - Muhammad Majid
- Faculty of Pharmacy, Hamdard University, Islamabad, Pakistan
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Haseeb A, Saleem Z, Maqadmi AF, Allehyani RA, Mahrous AJ, Elrggal ME, Kamran SH, AlGethamy M, Naji AS, AlQarni A, Alhariqi KW, Khan MA, Ibrahim K, Raees F, Azmat A, Cook A, Campbell SM, Lorenzetti G, Meyer JC, Godman B, Moore CE. Ongoing Strategies to Improve Antimicrobial Utilization in Hospitals across the Middle East and North Africa (MENA): Findings and Implications. Antibiotics (Basel) 2023; 12:827. [PMID: 37237730 PMCID: PMC10215537 DOI: 10.3390/antibiotics12050827] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 04/22/2023] [Accepted: 04/23/2023] [Indexed: 05/28/2023] Open
Abstract
Antimicrobial resistance (AMR) is an increasing global concern, increasing costs, morbidity, and mortality. National action plans (NAPs) to minimize AMR are one of several global and national initiatives to slow down rising AMR rates. NAPs are also helping key stakeholders understand current antimicrobial utilization patterns and resistance rates. The Middle East is no exception, with high AMR rates. Antibiotic point prevalence surveys (PPS) provide a better understanding of existing antimicrobial consumption trends in hospitals and assist with the subsequent implementation of antimicrobial stewardship programs (ASPs). These are important NAP activities. We examined current hospital consumption trends across the Middle East along with documented ASPs. A narrative assessment of 24 PPS studies in the region found that, on average, more than 50% of in-patients received antibiotics, with Jordan having the highest rate of 98.1%. Published studies ranged in size from a single to 18 hospitals. The most prescribed antibiotics were ceftriaxone, metronidazole, and penicillin. In addition, significant postoperative antibiotic prescribing lasting up to five days or longer was common to avoid surgical site infections. These findings have resulted in a variety of suggested short-, medium-, and long-term actions among key stakeholders, including governments and healthcare workers, to improve and sustain future antibiotic prescribing in order to decrease AMR throughout the Middle East.
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Affiliation(s)
- Abdul Haseeb
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah 24382, Saudi Arabia; (A.H.); (A.F.M.); (R.A.A.); (A.J.M.); (M.E.E.)
| | - Zikria Saleem
- Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan 60800, Pakistan
| | - Aseel Fayk Maqadmi
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah 24382, Saudi Arabia; (A.H.); (A.F.M.); (R.A.A.); (A.J.M.); (M.E.E.)
| | - Roaa Abdulrahman Allehyani
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah 24382, Saudi Arabia; (A.H.); (A.F.M.); (R.A.A.); (A.J.M.); (M.E.E.)
- Batterjee Medical College, Jeddah 21442, Saudi Arabia
| | - Ahmad J. Mahrous
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah 24382, Saudi Arabia; (A.H.); (A.F.M.); (R.A.A.); (A.J.M.); (M.E.E.)
| | - Mahmoud E. Elrggal
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah 24382, Saudi Arabia; (A.H.); (A.F.M.); (R.A.A.); (A.J.M.); (M.E.E.)
| | - Sairah Hafeez Kamran
- Institute of Pharmacy, Lahore College for Women University, Lahore 54000, Pakistan;
| | - Manal AlGethamy
- Department of Infection Prevention and Control Program, Alnoor Specialist Hospital, Makkah 24241, Saudi Arabia;
| | - Asem Saleh Naji
- Infectious Diseases Department, Alnoor Specialist Hospital, Makkah 24241, Saudi Arabia; (A.S.N.); (A.A.); (K.W.A.)
| | - Abdullmoin AlQarni
- Infectious Diseases Department, Alnoor Specialist Hospital, Makkah 24241, Saudi Arabia; (A.S.N.); (A.A.); (K.W.A.)
| | - Khalid W. Alhariqi
- Infectious Diseases Department, Alnoor Specialist Hospital, Makkah 24241, Saudi Arabia; (A.S.N.); (A.A.); (K.W.A.)
| | | | - Kiran Ibrahim
- Primary and Secondary Healthcare Department, DHQ Hospital Khushab, Khushab 41200, Pakistan;
| | - Fahad Raees
- Department of Medical Microbiology, Faculty of Medicine, Umm Al-Qura University, Makkah 24382, Saudi Arabia;
| | - Aisha Azmat
- Department of Physiology, Faculty of Medicine, Umm Al-Qura University, Makkah 24382, Saudi Arabia;
| | - Aislinn Cook
- Centre for Neonatal and Paediatric Infection, St. George’s University of London, London SW17 0RE, UK; (A.C.); (G.L.); (C.E.M.)
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford OX1 2JD, UK
| | - Stephen M. Campbell
- Centre for Epidemiology and Public Health, School of Health Sciences, University of Manchester, Manchester M13 9PL, UK;
- School of Pharmacy, Sefako Makgatho Health Sciences University, Ga-Rankuwa, Pretoria 0208, South Africa;
| | - Giulia Lorenzetti
- Centre for Neonatal and Paediatric Infection, St. George’s University of London, London SW17 0RE, UK; (A.C.); (G.L.); (C.E.M.)
| | - Johanna C. Meyer
- School of Pharmacy, Sefako Makgatho Health Sciences University, Ga-Rankuwa, Pretoria 0208, South Africa;
- South African Vaccination and Immunisation Centre, Sefako Makgatho Health Sciences University, Molotlegi Street, Garankuwa, Pretoria 0208, South Africa
| | - Brian Godman
- School of Pharmacy, Sefako Makgatho Health Sciences University, Ga-Rankuwa, Pretoria 0208, South Africa;
- Strathclyde Institute of Pharmacy and Biomedical Sciences, Strathclyde University, Glasgow G4 0RE, UK
- Centre of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman 346, United Arab Emirates
| | - Catrin E. Moore
- Centre for Neonatal and Paediatric Infection, St. George’s University of London, London SW17 0RE, UK; (A.C.); (G.L.); (C.E.M.)
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Hashmi A, Ul Haq MI, Malik M, Hussain A, Gajdács M, Jamshed S. Perceptions of community pharmacists regarding their role in antimicrobial stewardship in Pakistan: A way forward. Heliyon 2023; 9:e14843. [PMID: 37025891 PMCID: PMC10070906 DOI: 10.1016/j.heliyon.2023.e14843] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 03/20/2023] [Accepted: 03/20/2023] [Indexed: 03/28/2023] Open
Abstract
Background Antimicrobial resistance is one of the biggest challenges to healthcare resulting in increased morbidity and mortality, and associated with drug resistant infections. Community pharmacists (CPs) can play a key role in antimicrobial stewardship (AMS) programs to aid the prudent use of antibiotics, and in infection prevention and control. Objective The aim of this study was to assess perceptions of CPs regarding their role, awareness, collaboration, facilitators and barriers towards effective AMS practices in Pakistan. Method ology: A descriptive, cross-sectional study design was adopted, where convenience and snowball sampling methods were applied to enroll respondents (pharmacists working at these community pharmacies in different cities of Pakistan) of the study. After sample size determination, n = 386 CPs were enrolled. A pre-validated questionnaire was used regarding CPs roles and perceptions in association with AMS. Statistical analysis was performed using SPSS v. 21. Results The results of the study reported that 57.3% (n = 221) of CPs had strong familiarity with term AMS. 52.1% (n = 201) of CPs agreed that they require adequate training to undertake activities in AMS programmes in their setting. The results of the study showed that 92.7% (n = 358) of the pharmacists thought real time feedback would be helpful. Significant association was observed in AMS awareness, approach, collaboration and barriers with regards to the respondents' gender, age groups and levels of experience in a community pharmacy. Conclusions The study concluded that CPs were aware of AMS programmes, their relevance and necessity of AMS in their everyday practice, but had inadequate training and resources to implement it in Pakistan.
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Alshabi AM, Alshahrani MS, Abdel-Wahab BA, Khateeb MM, Shaikh IA, Mannasaheb BA. Predictors of antibiotic use in pregnant women attending Najran University Hospital, Saudi Arabia. Saudi Med J 2023; 44:314-319. [PMID: 36940957 PMCID: PMC10043894 DOI: 10.15537/smj.2023.44.3.20220762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 02/15/2023] [Indexed: 03/23/2023] Open
Abstract
OBJECTIVES To determine the prevalence of antibiotic use by pregnant women in Najran, Saudi Arabia. METHODS A total of 125 women aged 18 to 45 with a full-term pregnancy participated from October to December 2019. Age, order of current pregnancy, body mass index (BMI), history of miscarriage, and comorbidity were used to estimate antibiotic use. RESULTS The majority were Saudis (67.2%), aged 30-35 (39.2%) years, with no history of miscarriage (53.6%), second order of pregnancy (26.4%), and going through weeks 20-25 of pregnancy (21.6%). A total of 26.4% of pregnant women had antibiotic prescriptions in the study population. Pregnant women under 30 years were less likely to receive antibiotics. CONCLUSION The results found an association between maternal age, order of pregnancy and antibiotic use during pregnancy. An association was observed between maternal BMI and the occurrence of adverse drug reactions after antibiotic use. In addition, a history of miscarriage was negatively associated with the use of antibiotics during pregnancy. These predictors of antibiotic administration have the potential to serve as general health indicators and to direct preventative strategies aimed at increasing the rational use of antibiotics.
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Affiliation(s)
- Ali M. Alshabi
- From the Department of Clinical Pharmacy (Alshabi); from the Department of Pharmacology (Abdel-Wahab, Khateeb, Shaikh), College of Pharmacy; from the Department of Obstetrics and Gynecology (Alshahrani), Faculty of Medicine, Najran University, Najran, and from the Department of Pharmacy Practice (Mannasaheb), College of Pharmacy, AlMaarefa University, Riyadh, Kingdom of Saudi Arabia.
| | - Majed S. Alshahrani
- From the Department of Clinical Pharmacy (Alshabi); from the Department of Pharmacology (Abdel-Wahab, Khateeb, Shaikh), College of Pharmacy; from the Department of Obstetrics and Gynecology (Alshahrani), Faculty of Medicine, Najran University, Najran, and from the Department of Pharmacy Practice (Mannasaheb), College of Pharmacy, AlMaarefa University, Riyadh, Kingdom of Saudi Arabia.
| | - Basel A. Abdel-Wahab
- From the Department of Clinical Pharmacy (Alshabi); from the Department of Pharmacology (Abdel-Wahab, Khateeb, Shaikh), College of Pharmacy; from the Department of Obstetrics and Gynecology (Alshahrani), Faculty of Medicine, Najran University, Najran, and from the Department of Pharmacy Practice (Mannasaheb), College of Pharmacy, AlMaarefa University, Riyadh, Kingdom of Saudi Arabia.
| | - Masood M. Khateeb
- From the Department of Clinical Pharmacy (Alshabi); from the Department of Pharmacology (Abdel-Wahab, Khateeb, Shaikh), College of Pharmacy; from the Department of Obstetrics and Gynecology (Alshahrani), Faculty of Medicine, Najran University, Najran, and from the Department of Pharmacy Practice (Mannasaheb), College of Pharmacy, AlMaarefa University, Riyadh, Kingdom of Saudi Arabia.
| | - Ibrahim A. Shaikh
- From the Department of Clinical Pharmacy (Alshabi); from the Department of Pharmacology (Abdel-Wahab, Khateeb, Shaikh), College of Pharmacy; from the Department of Obstetrics and Gynecology (Alshahrani), Faculty of Medicine, Najran University, Najran, and from the Department of Pharmacy Practice (Mannasaheb), College of Pharmacy, AlMaarefa University, Riyadh, Kingdom of Saudi Arabia.
| | - Basheerahmed A. Mannasaheb
- From the Department of Clinical Pharmacy (Alshabi); from the Department of Pharmacology (Abdel-Wahab, Khateeb, Shaikh), College of Pharmacy; from the Department of Obstetrics and Gynecology (Alshahrani), Faculty of Medicine, Najran University, Najran, and from the Department of Pharmacy Practice (Mannasaheb), College of Pharmacy, AlMaarefa University, Riyadh, Kingdom of Saudi Arabia.
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Ibrahim SM, Adlan N, Alomair SM, Butaiban I, Alsalman A, Bawazeer A, Alqahtani M, Mohamed D, Emeka PM. Evaluation of Systemic Antifungal Prescribing Knowledge and Practice in the Critical Care Setting among ICU Physicians and Clinical Pharmacists: A Cross-Sectional Study. Antibiotics (Basel) 2023; 12:antibiotics12020238. [PMID: 36830149 PMCID: PMC9952359 DOI: 10.3390/antibiotics12020238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 01/18/2023] [Accepted: 01/20/2023] [Indexed: 01/24/2023] Open
Abstract
Management of invasive fungal infections (IFI) and subsequent treatment choices remain challenging for physicians in the ICU. Documented evidence shows increased practice of the inappropriate use of antifungal agents in the ICU. Continuous education of healthcare providers (HCPs) represents the cornerstone requirement for starting an antifungal stewardship program (AFS). This study aimed at evaluating knowledge gaps in systemic antifungal prescribing among physicians and clinical pharmacists in a critical care setting. A cross-sectional, multi-center, survey-based study was conducted in five tertiary hospitals located in Al-Ahsaa, Saudi Arabia between January and May 2021. A self-administered questionnaire was distributed among the targeted clinicians. A total of 63 clinicians were involved (65.5% ICU physicians and 34.5% clinical pharmacists). It was noted that a minority of the participating HCPs (3.2%) had overall good knowledge about antifungal prescribing, but the majority had either moderate (46%) or poor (50.8%) knowledge. The difference in overall knowledge scores between the ICU physicians and the clinical pharmacists (p = 0.925) was not significant. However, pharmacists showed better scores for the pharmacokinetics of antifungal therapy (p = 0.05). This study has revealed a significant gap in the knowledge and practice of clinicians as regards prescribing antifungal therapy in our area. Although the results cannot be generalized, the outcome of this study has exposed the need for a tailored training program essential for carrying out an AFS program.
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Affiliation(s)
- Sahar Mohamed Ibrahim
- Department of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al-Ahsaa 31982, Saudi Arabia
- Correspondence: (S.M.I.); (P.M.E.)
| | - Nosiyba Adlan
- Department of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al-Ahsaa 31982, Saudi Arabia
| | - Sufyan Mohammed Alomair
- Department of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al-Ahsaa 31982, Saudi Arabia
| | - Ibrahim Butaiban
- Department of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al-Ahsaa 31982, Saudi Arabia
| | - Ahmed Alsalman
- Department of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al-Ahsaa 31982, Saudi Arabia
| | - Abdulmajeed Bawazeer
- Department of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al-Ahsaa 31982, Saudi Arabia
| | - Monahi Alqahtani
- Department of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al-Ahsaa 31982, Saudi Arabia
| | - Dalia Mohamed
- Department of Pharmacy, Almoosa Specialist Hospital, Al-Ahsaa 31982, Saudi Arabia
| | - Promise Madu Emeka
- Department of Pharmaceutical Sciences, College of Clinical Pharmacy, King Faisal University, Al-Ahsaa 31982, Saudi Arabia
- Correspondence: (S.M.I.); (P.M.E.)
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9
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Hays JP, Safain KS, Almogbel MS, Habib I, Khan MA. Extended Spectrum- and Carbapenemase-Based β-Lactam Resistance in the Arabian Peninsula—A Descriptive Review of Recent Years. Antibiotics (Basel) 2022; 11:antibiotics11101354. [PMID: 36290012 PMCID: PMC9598294 DOI: 10.3390/antibiotics11101354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/29/2022] [Accepted: 10/01/2022] [Indexed: 11/23/2022] Open
Abstract
Antimicrobial resistance (AMR) is a global problem that also includes countries of the Arabian Peninsula. Of particular concern, is the continuing development of extended-spectrum β-lactamases (ESBLs) in the countries of this region. Additionally, antibiotic treatment options for ESBL-producing bacteria are becoming limited, primarily due to the continuing development of carbapenem resistance (CR), carbapenems being frequently used to treat such infections. An overview of recent publications (2018–2021) indicates the presence of ESBL and/or CR in patients and hospitals in most countries of the Arabian Peninsula, although the delay between microbial isolation and publication inevitably makes an accurate analysis of the current situation rather difficult. However, there appears to be greater emphasis on CR (including combined ESBL and CR) in recent publications. Furthermore, although publications from Saudi Arabia are the most prevalent, this may simply reflect the increased interest in ESBL and CR within the country. Enhanced ESBL/CR surveillance is recommended for all countries in the Arabian Peninsula.
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Affiliation(s)
- John Philip Hays
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Centre (Erasmus MC), Rotterdam 3015 GD, the Netherlands
| | - Kazi Sarjana Safain
- Department of Microbiological Sciences, North Dakota State University, Fargo, ND 58108, USA
| | | | - Ihab Habib
- Department of Veterinary Medicine, College of Agriculture and Veterinary Medicine, United Arab Emirates University, Al Ain P.O. Box 1555, United Arab Emirates
| | - Mushtaq Ahmad Khan
- Department of Medical Microbiology and Immunology, College of Medicine and Health Sciences, United Arab Emirates University (UAEU), Al Ain P.O. Box 15551, United Arab Emirates
- Zayed Center for Health Sciences, United Arab Emirates University (UAEU), Al Ain P.O. Box 15551, United Arab Emirates
- Correspondence: E-mail: ; Office phone: +971-3 7137480
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10
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Hashad N, Stewart D, Perumal D, Abdulrazzaq N, Tonna AP. The impact of COVID-19 on antimicrobial stewardship programme implementation in hospitals - an exploration informed by the Consolidated Framework for Implementation Research. J Hosp Infect 2022; 129:144-152. [PMID: 35998835 PMCID: PMC9396443 DOI: 10.1016/j.jhin.2022.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/15/2022] [Accepted: 08/15/2022] [Indexed: 11/19/2022]
Abstract
Introduction and objectives The disruption of antimicrobial stewardship programmes (ASPs) caused by coronavirus disease 2019 (COVID-19) has been recognized but not explored in depth. This study used a theoretical, qualitative approach to understand the impact of COVID-19 on ASP implementation in hospitals. Methods Semi-structured online interviews, informed by the Consolidated Framework for Implementation Research (CFIR), were conducted with ASP team members and non-members in hospitals. Participants were recruited via purposeful and snowball sampling with interviews video recorded, transcribed and analysed independently by two researchers based on mapping against CFIR constructs. Results Thirty-one interviews were conducted across 11 hospitals. The following themes were identified: (i) increased complexity of ASP implementation and changes in prescribing behaviour influenced by COVID-19; (ii) adaptations, networking and cosmopolitanism to enhance integration of COVID-19 management into ASP services; and (iii) adaptations and networking to support continuity of the ASP implementation process. A disruption to pre-pandemic ASP activities was reported, with complexity of COVID-19 overwhelming the healthcare system. ASP team members and services showed an ability to adapt and repurpose roles to respond to the pandemic. Interventions included developing national guidelines for treatment of patients with COVID-19 and contributing to guideline management and monitoring. A gradual restoration of ASP activities was perceived. Technological adaptations and enhancements in networking were reported as positive impacts of the pandemic. Conclusion Despite the initial disruption of ASP implementation caused by the pandemic, successful adaptation and evolution of ASP services reflects the high value and adaptability of ASP implementation in hospitals in the United Arab Emirates.
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Affiliation(s)
- N Hashad
- Pharmacy, Higher Colleges of Technology, Dubai, United Arab Emirates; Pharmacy and Life Sciences, Robert Gordon University, Aberdeen, UK
| | - D Stewart
- College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - D Perumal
- Commission of Academic Accreditation, Ministry of Education, Abu Dhabi, United Arab Emirates
| | - N Abdulrazzaq
- Al Kuwait Hospital, Emirates Health Services, Dubai, United Arab Emirates
| | - A P Tonna
- Pharmacy and Life Sciences, Robert Gordon University, Aberdeen, UK.
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11
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Edessa D, Sisay M, Hagos B, Amare F. Antimicrobial Use and Management of Childhood Diarrhea at Community Drug Retail Outlets in Eastern Ethiopia: A Matched Questionnaire-Based and Simulated Patient-Case Study. Pediatric Health Med Ther 2022; 13:63-79. [PMID: 35340354 PMCID: PMC8943828 DOI: 10.2147/phmt.s348204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 03/07/2022] [Indexed: 12/12/2022] Open
Abstract
Introduction Antimicrobial agents have saved millions of lives worldwide. However, inappropriate use has become a global concern leading to the emergence and spread of antimicrobial resistance (AMR). In this regard, the dispensing practices of pharmacy professionals in the community drug retail outlets (CDROs) plays a central role. Therefore, this study was aimed to assess the knowledge and dispensing practices of pharmacy professionals in the management of childhood diarrhea in CDROs of Eastern Ethiopia. Methods A community based cross-sectional study was conducted in 100 randomly selected CDROs in Eastern Ethiopia from 1 August to 30 September 2020. Data were collected with a structured questionnaire matched with a simulated patient case. Descriptive statistics were employed to summarize variables. Cohen's Kappa was analyzed to measure the degree of agreement between questionnaire-based and simulated patient-based methods. Binary logistic regression analysis was conducted to determine factors associated with inappropriate dispensing practice. Results Majority of the participants were aged 25-34 years (median: 29 years). High proportion of them were male (65%) and had work experiences of two or more years. Majority (61%) of the professionals were knowledgeable about AMR. Out of 2886 scores, 745 scores were agreed on Cohen's Kappa interrater agreement scale with the overall percent agreement between the two methods being 26.0%. Besides, about 67% of dispensing practices to the simulated patient case was found inappropriate. On the multivariate analysis, insufficient knowledge of retailers on AMR was significantly associated with the inappropriate dispensing of antimicrobial agents. Conclusion A considerable proportion of retailers had insufficient knowledge regarding the emergence and spread of AMR. Only a quarter of their questionnaire-based knowledge response agreed with simulated-patient-based actual practice, indicating weak agreement between the two methods and high level of inappropriate practice. Besides, insufficient knowledge of retailers was significantly associated with their inappropriate dispensing of antimicrobials.
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Affiliation(s)
- Dumessa Edessa
- Department of Clinical Pharmacy, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Mekonnen Sisay
- Department of Pharmacology and Toxicology, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Bisrat Hagos
- Department of Social Pharmacy, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Firehiwot Amare
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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12
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Nassar H, Abu-Farha R, Barakat M, Alefishat E. Antimicrobial Stewardship from Health Professionals' Perspective: Awareness, Barriers, and Level of Implementation of the Program. Antibiotics (Basel) 2022; 11:99. [PMID: 35052979 PMCID: PMC8773352 DOI: 10.3390/antibiotics11010099] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/07/2022] [Accepted: 01/11/2022] [Indexed: 02/04/2023] Open
Abstract
This study aimed to evaluate health professionals' perceptions regarding the level of implementation of the Antimicrobials Stewardship (AMS) programs in Jordanian tertiary hospitals and to assess the perceived barriers to its implementation. During this cross-sectional study, a total of 157 healthcare providers agreed to participate (response rate 96.3%). Participants were asked to complete an electronic survey after meeting them at their working sites. Only 43.9% of the healthcare providers (n = 69) reported having an AMS committee in their hospital settings. The results suggested that private hospitals have significantly better AMS implementation compared to public hospitals among four areas (p ≤ 0.05). Moreover, the results showed that the most widely available strategies to implement AMS were infectious disease/microbiology advice (n = 112, 71.3%), and treatment guidelines (n = 111, 70.7%). Additionally, the study revealed that the main barrier to AMS implementation was the lack of information technology support (n = 125, 79.6%). These findings could draw managers' attention to the importance of AMS and support the health care provider's practice of AMS in Jordanian tertiary hospitals by making the right decisions and the required modifications regarding the strategies needed for the implementation of AMS programs.
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Affiliation(s)
- Haya Nassar
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman 11931, Jordan; (H.N.); (R.A.-F.); (M.B.)
| | - Rana Abu-Farha
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman 11931, Jordan; (H.N.); (R.A.-F.); (M.B.)
| | - Muna Barakat
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman 11931, Jordan; (H.N.); (R.A.-F.); (M.B.)
| | - Eman Alefishat
- Department of Pharmacology, College of Medicine and Health Science, Khalifa University of Science and Technology, Abu Dhabi P.O. Box 127788, United Arab Emirates
- Center for Biotechnology, Khalifa University of Science and Technology, Abu Dhabi P.O. Box 127788, United Arab Emirates
- Department Biopharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, The University of Jordan, Amman 11942, Jordan
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13
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Knowledge, Awareness and Practice with Antimicrobial Stewardship Programmes among Healthcare Providers in a Ghanaian Tertiary Hospital. Antibiotics (Basel) 2021; 11:antibiotics11010006. [PMID: 35052883 PMCID: PMC8773036 DOI: 10.3390/antibiotics11010006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/14/2021] [Accepted: 12/19/2021] [Indexed: 12/31/2022] Open
Abstract
Antimicrobial resistance (AMR) is a significant problem in global health today, particularly in low- and middle-income countries (LMICs) where antimicrobial stewardship programmes are yet to be successfully implemented. We established a partnership between AMR pharmacists from a UK NHS hospital and in Ho Teaching Hospital with the aim of enhancing antimicrobial stewardship knowledge and practice among healthcare providers through an educational intervention. We employed a mixed-method approach that included an initial survey on knowledge and awareness before and after training, followed by qualitative interviews with healthcare providers conducted six months after delivery of training. This study was carried out in two phases in Ho Teaching Hospital with healthcare professionals, including pharmacists, medical doctors, nurses and medical laboratory scientists. Ethical approval was obtained prior to data collection. In the first phase, we surveyed 50 healthcare providers, including nurses (33%), pharmacists (29%) and biomedical scientists (23%). Of these, 58% of participants had engaged in continuous professional development on AMR/AMS, and above 95% demonstrated good knowledge on the general use of antibiotics. A total of 18 participants, which included four medical doctors, five pharmacists, four nurses, two midwives and three biomedical scientists, were interviewed in the second phase and demonstrated greater awareness of AMS practices, particularly the role of education for patients, as well as healthcare professionals. We found that knowledge and practice with AMS was markedly improved six months after the training session. There is limited practice of AMS in LMICs; however, through AMR-focused training, we demonstrated improved AMS skills and practice among healthcare providers in Ho Teaching Hospital. There is a need for continuous AMR training sessions for healthcare professionals in resource-limited settings.
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14
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Herawati F, Jaelani AK, Wijono H, Rahem A, Setiasih, Yulia R, Andrajati R, Soemantri D. Antibiotic stewardship knowledge and belief differences among healthcare professionals in hospitals: A survey study. Heliyon 2021; 7:e07377. [PMID: 34222701 PMCID: PMC8243519 DOI: 10.1016/j.heliyon.2021.e07377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 05/25/2021] [Accepted: 06/18/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Collaborative practice in healthcare has been recommended to improve the quality of antimicrobial stewardship interventions, a behavioral change in antimicrobial use. Insufficient knowledge regarding antibiotic resistance, the fear of complications from infections, and how providers perceive antibiotic use and resistance are likely to influence prescribing behavior. This study's objective was to identify the knowledge and belief healthcare professionals' differences about antibiotic stewardship. METHODS This cross-sectional survey study of three hospitals in the East Java province, Indonesia utilized a 43-item questionnaire to assess antimicrobial stewardship knowledge and belief. There were 12 knowledge questions (total possible score: 12) and 31 belief questions (total possible score: 155). The Kuder Richardson 20 (KR-20) and Cronbach alpha values of the questionnaire were 0.54 and 0.92, respectively. RESULTS Out of the 257 respondents, 19% (48/257) had a low scores of knowledge, and 39% (101/257) had low scores on belief about antibiotic stewardship (101/257). Most midwives had a low scores on knowledge (25/61) and low scores on belief (46/61). Respondents with high scores on belief were 17% (10/59) physicians, 15% (4/27) pharmacists, 8% (5/65) nurses, and 3% (2/61) midwives. CONCLUSION Among healthcare professionals, knowledge and belief differences concerning antibiotic stewardship vary widely. These differences will affect their capability, behavior, and contribution to the healthcare team collaboration and performance. Further studies are needed to evaluate the correlation between the level of inter-professional collaboration and the quality of the antibiotic stewardship implementation.
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Affiliation(s)
- Fauna Herawati
- Department of Clinical and Community Pharmacy, Faculty of Pharmacy, Universitas Surabaya, Surabaya, 60293, Indonesia
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Indonesia, Depok, 16424, Indonesia
| | | | - Heru Wijono
- Faculty of Medicine, Universitas Surabaya, Surabaya, 60293, Indonesia
| | - Abdul Rahem
- Community Pharmacy Department, Faculty of Pharmacy, Airlangga University, Surabaya, 60115, Indonesia
| | - Setiasih
- Laboratory for Developmental Psychology, Faculty of Psychology, Universitas Surabaya, Surabaya, 60293, Indonesia
| | - Rika Yulia
- Department of Clinical and Community Pharmacy, Faculty of Pharmacy, Universitas Surabaya, Surabaya, 60293, Indonesia
| | - Retnosari Andrajati
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Indonesia, Depok, 16424, Indonesia
| | - Diantha Soemantri
- Department of Medical Education, Faculty of Medicine, Universitas Indonesia, Depok, 16424, Indonesia
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15
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Al Salman J, Al Dabal L, Bassetti M, Alfouzan WA, Al Maslamani M, Alraddadi B, Elhoufi A, Khamis F, Mokkadas E, Romany I, Enani M, Somily A, Kanj SS. Promoting cross-regional collaboration in antimicrobial stewardship: Findings of an infectious diseases working group survey in Arab countries of the Middle East. J Infect Public Health 2021; 14:978-984. [PMID: 34130122 DOI: 10.1016/j.jiph.2021.04.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 04/08/2021] [Accepted: 04/19/2021] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Antimicrobial resistance is a significant global issue that presents an increasing threat to patients' wellbeing. Although a global concern, the emergence of multi-drug resistant organisms is of particular significance in the Middle East. In recent years, this region has seen an alarming increase in antimicrobial resistance presenting a major challenge to physicians managing various infectious diseases. METHODS A Working Group comprising experts in infectious diseases from Arab countries of Middle East assembled to review similarities and differences in antimicrobial practices and management of multi-drug resistant organisms across the region and assess the barriers to achieving cross-regional collaboration. The Working Group conducted an anonymous online survey to evaluate current practice and understanding of management of multi-drug resistant organisms across the region. RESULTS A total of 122 physicians from Arab countries of the Middle East responded to the survey. Their responses demonstrated heterogeneity between countries in awareness of local epidemiology, management of multi-drug resistant organisms and antimicrobial stewardship practices. The Working Group recognized similarities and differences in the management of multi-drug resistant organisms across the region, and these were validated by the data collected in the survey. Overall, the similarities across the region reflect several key issues that can have an impact on the management of multi-drug resistant organisms and the prevention of antimicrobial resistance. CONCLUSIONS This paper highlights the urgency of addressing antimicrobial resistance in Arab countries of the Middle East. The Working Group identified key barriers to effective management which may guide the development of future coherent strategies to promote effective antimicrobial stewardship in the region. Here, we outline a call to action for the region, with a need to focus on training and education, capacity building, infrastructure, regional research, and regional surveillance.
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Affiliation(s)
| | | | - Matteo Bassetti
- Infectious Diseases Clinic, Department of Health Sciences University of Genoa and Policlinico San Martino Hospital, Genoa, Italy
| | - Wadha A Alfouzan
- Kuwait University, Kuwait City, Kuwait; Farwanyia Hospital, Ministry of Health, Kuwait City, Kuwait
| | | | - Basem Alraddadi
- King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia; Alfaisal University, Riyadh, Saudi Arabia
| | | | | | | | - Ingy Romany
- Pfizer Gulf FZ LLC, Dubai, United Arab Emirates
| | | | - Ali Somily
- King Saud University and King Saud University Medical City, Riyadh, Saudi Arabia
| | - Souha S Kanj
- American University of Beirut Medical Center, Beirut, Lebanon.
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16
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Ababneh MA, Nasser SA, Rababa'h AM. A systematic review of Antimicrobial Stewardship Program implementation in Middle Eastern countries. Int J Infect Dis 2021; 105:746-752. [PMID: 33737132 DOI: 10.1016/j.ijid.2021.03.035] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 03/02/2021] [Accepted: 03/10/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Antimicrobial resistance is a serious threat to global health. Antimicrobial Stewardship Programs (ASPs) are adopted by healthcare systems worldwide. This review aimed to evaluate the published practices of ASPs in Middle Eastern countries. METHODS Searches were carried out in PubMed/MEDLINE, Embase, EBSCO, Cochrane Library, Google, and Google Scholar electronic databases for studies published from January 2005 to December 2020 that assessed ASP practices in Middle Eastern countries, following PRISMA guidelines. RESULTS Of the 422 titles identified, 20 studies met the inclusion criteria. Eight studies were conducted in the Kingdom of Saudi Arabia, five in Qatar, two each in Lebanon and Jordan, and one each in Palestine and UAE; there was also one multinational study. Different ASP practices, including prospective auditing and feedback, pre-authorization, tracking, antibiotic restriction, education, de-escalation, and intravenous-to-oral switch, were reported. ASP practices correlated with improved susceptibility rates and decreases in antimicrobial use. CONCLUSION The outcomes of this review reveal the scarcity of data on ASP practices. The introduction of ASPs in hospitals in Middle Eastern countries has led to favorable clinical effects. Policymakers and stakeholders should promote and invest in implementing these programs as an essential component of their healthcare systems.
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Affiliation(s)
- Mera A Ababneh
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan.
| | - Sara A Nasser
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Abeer M Rababa'h
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
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17
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Alghamdi S, Berrou I, Aslanpour Z, Mutlaq A, Haseeb A, Albanghali M, Hammad MA, Shebl N. Antimicrobial Stewardship Programmes in Saudi Hospitals: Evidence from a National Survey. Antibiotics (Basel) 2021; 10:193. [PMID: 33671401 PMCID: PMC7923167 DOI: 10.3390/antibiotics10020193] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 02/06/2021] [Accepted: 02/15/2021] [Indexed: 12/16/2022] Open
Abstract
Saudi hospitals and healthcare facilities are facing increasing rates of antimicrobial resistance and the emergence of new multi-drug resistant strains. This is placing an unprecedented threat to successful treatments and outcomes of patients accessing those facilities. The inappropriate use of antimicrobials is fueling this crisis, warranting urgent implementation of interventions to preserve antimicrobials and reduce resistance rates. Antimicrobial stewardship programmes (ASPs) can improve antimicrobial use, treatment success rates and reduce the levels of antimicrobial resistance. The Saudi Ministry of Health (MOH) devised a national antimicrobial stewardship plan to implement ASPs in hospitals, but little is known about the progress of implementation and the factors affecting it. This study aims to assess the level and the factors affecting the adoption and implementation of ASPs in Saudi hospitals at a national level. A nationwide cross-sectional survey was conducted in 2017 using an online questionnaire sent to all MOH hospitals. Overall, 147 out 247 MOH hospitals responded to the survey (54%). Only 26% of the hospitals reported the implementation of ASPs. Hospitals lack the knowledge, technological and staff resources to adopt and implement ASPs. Alternative models of ASP adoption could be explored to improve the rates of implementation of ASPs.
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Affiliation(s)
- Saleh Alghamdi
- Department of Clinical Pharmacy, Faculty of Clinical Pharmacy, Albaha University, Albaha, Saudi Arabia; (S.A.); (M.A.H.)
| | - Ilhem Berrou
- School of Health and Wellbeing, Faculty of Health and Applied Sciences, University of the West of England, Bristol BS16 1DD, UK
| | - Zoe Aslanpour
- Department of Clinical, Pharmaceutical and Biological Sciences, School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9AB, UK; (Z.A.); (N.S.)
| | - Alaa Mutlaq
- General Department of Pharmaceutical Care, Ministry of Health, Riyadh, Saudi Arabia;
| | - Abdul Haseeb
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al Qura University, Makkah, Saudi Arabia;
| | - Mohammad Albanghali
- Department of Public Health, Faculty of Applied Medical Sciences, Albaha University, Albaha, Saudi Arabia;
| | - Mohamed Anwar Hammad
- Department of Clinical Pharmacy, Faculty of Clinical Pharmacy, Albaha University, Albaha, Saudi Arabia; (S.A.); (M.A.H.)
| | - Nada Shebl
- Department of Clinical, Pharmaceutical and Biological Sciences, School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9AB, UK; (Z.A.); (N.S.)
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18
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Khasawneh RA, Ababneh MA, Al-Azzam SI. Antimicrobial stewardship programs: perceptions and practices among Jordanian healthcare practitioners. JOURNAL OF PHARMACEUTICAL HEALTH SERVICES RESEARCH 2021. [DOI: 10.1093/jphsr/rmaa034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Abstract
Objective
Antimicrobial stewardship programs are of paramount importance in containing antibiotic resistance and combat the acquisition of multi-drug resistance strains. Healthcare practitioners, specifically physicians and clinical pharmacists are the direct clinical antibiotic prescribing authorities. Therefore, this study aimed to assess Jordanian practitioners' perceptions and practices towards antimicrobial stewardship programs.
Methods
This was a cross-sectional study, in which physicians and clinical pharmacists were approached to fill out a previously validated study instrument. A close-ended structured questionnaire comprising 34 questions covering aspects related to antimicrobial stewardship program perceptions, practices and participants' demographic data were used to collect pertinent information.
Key findings
A total of 286 participants were enrolled in the study. There was an overall positive perception towards antimicrobial stewardship programs, while practices related to this element was still suboptimal. Additional comparison of the overall perception scores among different demographic characteristics showed that long years of practice, postgraduate studies and practice in academic sectors yielded higher perception scores (P = 0.0335, 0.0328 and 0.0007, respectively).
Conclusion
There is an imminent need to enhance Jordanian practitioners' knowledge about antimicrobial stewardship programs. Clear recognition of integral antimicrobial stewardship programs' components must be coupled with highlight changes in current practices related to antimicrobials usage and prescription.
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Affiliation(s)
- Rawand A Khasawneh
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Mera A Ababneh
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Sayer I Al-Azzam
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
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19
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Doctors' Perceptions, Attitudes and Practices towards the Management of Multidrug-Resistant Organism Infections after the Implementation of an Antimicrobial Stewardship Programme during the COVID-19 Pandemic. Trop Med Infect Dis 2021; 6:tropicalmed6010020. [PMID: 33562723 PMCID: PMC7930958 DOI: 10.3390/tropicalmed6010020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 02/02/2021] [Accepted: 02/02/2021] [Indexed: 12/26/2022] Open
Abstract
Background: Greece is among the European countries with the highest consumption of antibiotics, both in community and hospital settings, including last-line antibiotics, such as carbapenems. We sought to explore doctors’ perceptions, attitudes and practices towards the management of patients with multidrug-resistant organism (MDRO) infections after the implementation of an antimicrobial stewardship programme (ASP) in a tertiary academic hospital during the COVID-19 pandemic. Methods: A self-administered, internet-based questionnaire survey was completed by doctors of the University Hospital of Heraklion in Crete, Greece. Results: In total, 202 (59.1%) hospital doctors fully completed the questionnaire. Most of them agreed that the prospective audit and feedback ASP strategy is more effective and educational than the preauthorization ASP strategy. ASP implementation prompted most respondents to monitor the continuously evolving microbiological data of their patients more closely and affected them towards a multidisciplinary and personalised care of patients with infections caused by MDROs and towards a more rigorous implementation of infection prevention and control measures. The vast majority of participants (98.5%) stated that ASP must be continued and further developed during the COVID-19 pandemic. Conclusion: The ASP implementation in our hospital had a beneficial impact on doctors’ perceptions, attitudes and practices with regard to the management of infections due to MDROs.
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20
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Dutescu IA, Hillier SA. Encouraging the Development of New Antibiotics: Are Financial Incentives the Right Way Forward? A Systematic Review and Case Study. Infect Drug Resist 2021; 14:415-434. [PMID: 33574682 PMCID: PMC7872909 DOI: 10.2147/idr.s287792] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 12/25/2020] [Indexed: 12/11/2022] Open
Abstract
Antibiotic resistance is an urgent public health threat that has received substantial attention from the world's leading health agencies and national governmental bodies alike. However, despite increasing rates of antibiotic resistance, pharmaceutical companies are reluctant to develop new antibiotics due to scientific, regulatory, and financial barriers. Nonetheless, only a handful of countries have addressed this by implementing or proposing financial incentive models to promote antibiotic innovation. This study is comprised of a systematic review that aimed to understand which antibiotic incentive strategies are most recommended within the literature and subsequently analyzed these incentives to determine which are most likely to sustainably revitalize the antibiotic pipeline. Through a case study of Canada, we apply our incentive analysis to the Canadian landscape to provide decision-makers with a possible path forward. Based on our findings, we propose that Canada support the ongoing efforts of other countries by implementing a fully delinked subscription-based market entry reward. This paper seeks to spark action in Canada by shifting the national paradigm to one where antibiotic research and development is prioritized as a key element to addressing antibiotic resistance.
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Affiliation(s)
- Ilinca A Dutescu
- School of Health Policy & Management, Faculty of Health, York University, Toronto, ON, Canada
| | - Sean A Hillier
- School of Health Policy & Management, Faculty of Health, York University, Toronto, ON, Canada
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21
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Baraka MA, AlLehaibi LH, AlSuwaidan HN, Alsulaiman D, Islam MA, Alotaibi BS, Alboghdadly A, Homoud AH, Al-Ghamdi FH, Al Ghamdi MS, Babar ZUD. Patterns of infections and antimicrobial drugs' prescribing among pregnant women in Saudi Arabia: a cross sectional study. J Pharm Policy Pract 2021; 14:9. [PMID: 33441164 PMCID: PMC7807808 DOI: 10.1186/s40545-020-00292-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 12/28/2020] [Indexed: 12/13/2022] Open
Abstract
Background Antimicrobial agents are among the most commonly prescribed drugs in pregnancy due to the increased susceptibility to infections during pregnancy. Antimicrobials can contribute to different maternal complications. Therefore, it is important to study their patterns in prescription and utilization. The data regarding this issue is scarce in Saudi Arabia. Therefore, the aim of this study is to generate data on the antimicrobial agents that are most commonly prescribed during pregnancy as well as their indications and safety. Methods This is a retrospective study focusing on pregnant women with a known antimicrobial use at Johns Hopkins Aramco Healthcare (JHAH). The sample included 344 pregnant women with a total of 688 antimicrobial agents prescribed. Data was collected on the proportion of pregnant women who received antimicrobial agents and on the drug safety during pregnancy using the risk categorization system of the U.S. Food and Drug Administration (FDA). Results The results showed that urinary tract infections (UTIs) were the most reported (59%) infectious diseases. Around 48% of pregnant women received antimicrobial medications at some point during pregnancy. The top two antimicrobial agents based on prescription frequency were B-lactams (44.6%) and azole anti-fungals (30%). The prescribed drugs in the study were found to be from classes B, C and D under the FDA risk classification system. Conclusion The study revealed a high proportion of antimicrobials prescribed during pregnancy that might pose risks to mothers and their fetuses. Future multicenter studies are warranted to evaluate the rational prescription of antimicrobial medications during pregnancy.
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Affiliation(s)
- Mohamed A Baraka
- Clinical Pharmacy Department, College of Pharmacy, Al Ain University, Al Ain Campus, Al Ain, United Arab Emirates. .,Clinical Pharmacy Department, College of Pharmacy, Al-Azhar University, Cairo, Egypt.
| | - Lina Hussain AlLehaibi
- First Health Cluster in Eastern Province, Dammam Medical Complex, Dammam, 32245, Saudi Arabia
| | - Hind Nasser AlSuwaidan
- College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, P.O. Box. 1982, Dammam, 31441, Saudi Arabia
| | - Duaa Alsulaiman
- King Fahd Hospital of the University (KFHU), Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Md Ashraful Islam
- Pharmacy Practice Department, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Badriyah Shadid Alotaibi
- Department of Pharmaceutical Sciences, College of Pharmacy, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Amany Alboghdadly
- College of Pharmacy, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Ali H Homoud
- Clinical Pharmacy Service, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
| | - Fuad H Al-Ghamdi
- Pharmacy Department at Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
| | - Mastour S Al Ghamdi
- Department of Pharmacology, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Zaheer-Ud-Din Babar
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield, UK
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22
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Babatola AO, Fadare JO, Olatunya OS, Obiako R, Enwere O, Kalungia A, Ojo TO, Sunmonu TA, Desalu O, Godman B. Addressing antimicrobial resistance in Nigerian hospitals: exploring physicians prescribing behavior, knowledge, and perception of antimicrobial resistance and stewardship programs. Expert Rev Anti Infect Ther 2020; 19:537-546. [PMID: 32990480 DOI: 10.1080/14787210.2021.1829474] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
INTRODUCTION We assessed the knowledge of, attitude toward antimicrobial resistance (AMR) and practice of antimicrobial stewardship (AMS) among physicians in Nigeria to provide future guidance to the Nigerian National Action Plan for AMR. METHODS A descriptive cross-sectional questionnaire-based study explored the physicians' self-reported practice of antibiotic prescribing, knowledge, attitude, and practice of AMR and components of ASPs. RESULTS The majority (217; 67.2%) of respondents prescribed antibiotics daily in their clinical practice AMR was recognized as a global and local problem by 308 (95.4%) and 262 (81.1%) respondents, respectively. Only 91 (28.2%) of respondents have ever heard of antibiotic stewardship. The median AMR knowledge score was 40 (19-45)out of 45while that for ASP was 46.0(32-57) out of 60. There was significant statistical difference between the ASP median scores among the medical specialties category (P value <0.0001) More respondents had good knowledge of AMR than ASPs (82.7% versus 36.5%; p < 0.0001). CONCLUSION Respondents in this study were more knowledgeable about AMR than AMS and its core components.
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Affiliation(s)
- Adefunke O Babatola
- Department of Paediatrics, Ekiti State University, Ado-Ekiti, Nigeria.,Department of Paediatrics, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
| | - Joseph O Fadare
- Department of Pharmacology and Therapeutics, Ekiti State University, Ado-Ekiti, Nigeria.,Department of Medicine, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
| | - Oladele S Olatunya
- Department of Paediatrics, Ekiti State University, Ado-Ekiti, Nigeria.,Department of Paediatrics, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
| | - Reginald Obiako
- Department of Clinical Pharmacology, Ahmadu Bello University, Zaria, Nigeria.,Department of Medicine, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| | - Okezie Enwere
- Department of Medicine, Imo State University, Orlu, Nigeria
| | - Aubrey Kalungia
- Department of Pharmacy, University of Zambia, Lusaka, Zambia
| | - Temitope O Ojo
- Department of Community Medicine, Obafemi Awolowo University, Ile-Ife, Nigeria
| | | | - Olufemi Desalu
- Department of Medicine, University of Ilorin, Ilorin, Nigeria
| | - Brian Godman
- Department of Pharmacy, Faculty of Health Sciences, School of Health Care Sciences, Sefako Makgatho Health Sciences University, Pretoria, South Africa.,Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK.,Health Economics Centre, University of Liverpool Management School, Liverpool, UK.,Division of Clinical Pharmacology, Karolinska Institute, Karolinska University Hospital Huddinge, Stockholm, Sweden
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23
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Hashad N, Perumal D, Stewart D, Tonna AP. Mapping hospital antimicrobial stewardship programmes in the Gulf Cooperation Council states against international standards: a systematic review. J Hosp Infect 2020; 106:404-418. [PMID: 32911008 DOI: 10.1016/j.jhin.2020.09.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 09/01/2020] [Indexed: 02/04/2023]
Abstract
BACKGROUND While there is evidence of implementation of antimicrobial stewardship programmes (ASPs) in the Gulf Cooperation Council (GCC) states, there has been limited benchmarking and mapping to international standards and frameworks. AIM To critically appraise and synthesize the evidence of ASP implementation in GCC hospitals with reference to the framework of the Centers for Disease Control and Prevention (CDC), identifying key facilitators and barriers. METHODS A systematic review protocol was developed based on Preferred Reporting Items for Systematic Reviews and Meta-analyses for Protocols guidelines. Five electronic databases were searched for studies published in English from 2010 onwards. Study selection, quality assessment and data extraction were performed independently by two reviewers. A narrative synthesis was conducted with ASP interventions mapped to CDC core elements. FINDINGS Seventeen studies were identified, most of which (N=11) were from Saudi Arabia. Mapping to the CDC framework identified key areas of strengths and weaknesses in reporting implementation. Studies more commonly reported core elements of pharmacy expertise, selected aspects of implementation actions, tracking, antibiotic use and resistance, and education. Little emphasis was placed on the reporting of leadership and accountability. Key implementation facilitators were physician and organization support, information systems and education, and barriers were dedicated staff, workload and funding. CONCLUSION There is a need to enhance the reporting of ASP implementation in GCC hospitals. The CDC framework should be used as a guide during the development, implementation and reporting of ASP interventions. Action is required to identify facilitators and overcome barriers, where possible.
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Affiliation(s)
- N Hashad
- School of Pharmacy and Life Sciences, Robert Gordon University, Aberdeen, UK
| | - D Perumal
- Commission of Academic Accreditation, Ministry of Education, IPIC Tower, Abu Dhabi, UAE
| | - D Stewart
- College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - A P Tonna
- School of Pharmacy and Life Sciences, Robert Gordon University, Aberdeen, UK.
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24
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Evaluation of Antimicrobial Stewardship Programs (ASPs) and their perceived level of success at Makkah region hospitals, Kingdom of Saudi Arabia. Saudi Pharm J 2020; 28:1166-1171. [PMID: 33132709 PMCID: PMC7584782 DOI: 10.1016/j.jsps.2020.08.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 08/08/2020] [Indexed: 02/07/2023] Open
Abstract
Antimicrobial stewardship programs (ASPs) are collaborative efforts to optimize antimicrobial use in healthcare institutions through evidence-based quality improvement strategies. The general administration of pharmaceutical care in the Saudi ministry of health (MOH) is putting outstanding efforts in implementing antimicrobial stewardship in Saudi health care settings. Several surveys have been conducted globally and reported many types of antimicrobial stewardship strategies in health institutions and their effectiveness. This study aims to identify ASPs in Makkah region hospitals and their perceived level of success. We administered a regional survey to explore current progress and issues related to the implementation of ASPs in Makkah region hospitals at the pharmacy level (n = 25). Among responding hospitals, 19 (76%) hospitals, the most commonly reported ASP were as following: formulary restrictions (90%) for broad-spectrum antimicrobials and use of prospective feedback on antimicrobial prescribing (68%), use of clinical guidelines and pathways (100%), and use of automatic stop orders (68%) to limit inappropriate antimicrobial therapy. The study outcomes will also be of pivotal importance to devise policies and strategies for antimicrobial stewardship implementation in other non-MOH settings in the Makkah region. Based on our results, all reported institutions have at least one antimicrobial stewardship program in a process with a high success rate. A multidisciplinary ASP approach, active involvement of drug & therapeutic committee, formulary restrictions, and availability of education & training of pharmacists and physicians on ASP are the primary elements for perceived successful antimicrobial stewardship programs in the Makkah region hospitals.
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