Infection, Disease Control and Prevention

Biography

Biography: Upasana Acharya

Abstract

Antimicrobial Stewardship Program (ASP) aims at optimizing antimicrobial selection, dosing, route, and duration of therapy to maximize clinical cure or prevention of infection while limiting the unintended consequences, such as the emergence of resistance, adverse drug events, and cost. While ASP is embraced by most hospitals in developed world that is not the case in most low resource countries. Grande International Hospital, a multi-specialty tertiary care center, is the only hospital in Nepal where this system is being implemented since last three years. Mobilizing the needed support from the hospital leadership, Clinicians, Pharmacists, Laboratory Personnel and Nursing staff, a system of taking an approval from the ASP Committee before using certain antimicrobials is in place. A comparative retrospective observational study was conducted to evaluate the impact of ASP throughout the hospital for restricted antimicrobials. The pattern of Antimicrobial usage data six months before (October 2013 to March, 2014) and after the commencement of ASP program (April to September 2014) was analyzed.The results showed that despite the increase in inpatient admission, the consumption of higher antibiotics was reduced. For example, following the commencement of ASP, the use of Vancomycin and Colistin was reduced by about 50 % and use of Amikacin and Gentamycin was reduced by about 30%. Beta lactamase inhibitor combination use also decreased by 7%. Antimicrobial stewardship program, if implemented effectively, helps control the inappropriate use of antibiotics in the hospital setting and thereby reducing the risk of emergence of drug resistant organisms, adverse drug effects and cost.