PT  - JOURNAL ARTICLE
AU  - Alawi, Maha M.
AU  - Darwesh, Bayan M.
TI  - A stepwise introduction of a successful antimicrobial stewardship program
AID  - 10.15537/smj.2016.12.15739
DP  - 2016 Dec 01
TA  - Saudi Medical Journal
PG  - 1350--1358
VI  - 37
IP  - 12
4099  - http://smj.org.sa/content/37/12/1350.short
4100  - http://smj.org.sa/content/37/12/1350.full
SO  - Saudi Med J2016 Dec 01; 37
AB  - Objectives To analyze and evaluate the safety and cost-effectiveness of a gradually-implemented antimicrobial stewardship programs (ASP) in a tertiary care center.Methods Prospective data were collected from an ASP that was gradually introduced between April 2012 and December 2013 in 6 hospital departments, over successive periods of 3 months each. A multidisciplinary team supervised antibiotic use and regulated pharmacy dispensations of a list of restricted antimicrobials (RAs). Indicators were prospectively monitored and included hospital mortality as the safety indicator; incidence of multi-drug resistance (MDR) infections as the effectiveness indicator, RA cost savings as the cost-effectiveness indicator and RA consumption indicated the process implementation.Results Between 2012 and 2014, dispensations of RAs decreased by 67% and prescriptions by 75%; no increase in mortality rate was observed. Microbiologically, there was a decreasing trend of incidence across all monitored infections, but this was only significant for Acinetobacter baumannii (p=0.007). Cost analysis showed a decrease in expenditure for RAs, with an average monthly saving of up to 326,020USD.Conclusions Stepwise implementation of ASPs is a safe and cost-effective strategy for improving antibiotic prescribing practice and to reduce multi-drug resistance.