ABSTRACT
Backgrounds and Objective: Antimicrobial resistance is an alarming public health threat that requires urgent global solution. Implementation of antimicrobial stewardship program [ASP] is an essential practice element for healthcare institutions in gate-keeping judicious antimicrobial use. This study highlighted the development, first year experience, and result of the implementation of ASP utilizing persuasive and restrictive approaches in a Malaysian district hospital
Methods: An observational study was conducted between January 2015 to December 2015 on implementation of ASP among hospitalized inpatients age 12 years old and above
Results: Recommendations were provided for 60% of cases [110 patients] with the average acceptance rate of 83.33%. Majority of the interventions were to stop the antimicrobial therapy [30.3%], and the most common audited antimicrobials was Piperacillin/ Tazobactam [25.5%], followed by Meropenem [11.82%], Amoxicillin/Clavulanate and Vancomycin [8.18%] respectively
The concordance rate towards authorization policy was increased in 2015 [71.59% of cases] as compared before the implementation of ASP in 2014 [60.6% of cases]
Restrictive enforcement under ASP had been shown to improve significantly adherence rate towards antimicrobials authorization policy [p-value: 0.004]
Conclusion: ASP was successfully implemented in a district hospital. Future studies on its clinical outcomes are important to evaluate its effectiveness as well as focus on the improvement to the pre-existing strategies and measures