Hospital Antibiogram- A Tool for Safe Antimicrobial Therapy.

ABSTRACT

Monitoring emerging trends in antimicrobial resistance at local levels is a very important aspect for clinical decision making and infection control interventions in this era of rising superbugs. The hospital antibiogram constructed by standardized methods is a summary of antimicrobial susceptibilities of local bacterial isolates, with periodic review.METHODSThis antibiogram was prepared based on the Clinical and Laboratory Standards Institute (CLSI) M39 – A4 guidelines. The data was collected for a period of three years from May 2016 to April 2019. All the samples which were received in the microbiology laboratory for aerobic bacterial culture and sensitivity testing were considered. Antibiotic susceptibility data of the bacterial isolates processed by VITEK2 system was considered. A hospital antibiotic policy was formulated and implemented.RESULTSA total of 15,135 samples were analysed from different clinical departments for a period of three years, of which 5,638 were culture positive. A comparative analysis of the three years’ data during the introduction of antibiotic protocol showed a gradual decrease in the rate of infection with multidrug resistant organisms. The prevalence of Methicillin Resistant Staphylococcus aureus (MRSA) showed a decrease from 15% to 7%. Extended spectrum beta-lactamase (ESBL) producing Escherichia coli in urine decreased from 42.4% to 27%.CONCLUSIONSPrompt antimicrobial therapy in case of an infection makes a lot of difference between recovery and death and most of the time prevents long term disability. Hence, antibiotic policy is one of the mandatory requirements, and making an antibiogram is the first step before framing antibiotic policy.