Impact of Antimicrobial Stewardship Intervention on Antibiotic Prescribing Practices in the Paediatric Unit of a Tertiary Hospital: Using Global-Point Prevalence Survey as a Tool
DOI:
https://doi.org/10.30442/ahr.1101-02-266Keywords:
Antibiotics, Antimicrobial Resistance, Antimicrobial Stewardship Program, Biomarkers, Paediatrics, Global-PPS, Quality indicatorsAbstract
Background: Antimicrobial Stewardship programs help to promote the appropriate use of antibiotics, thereby reducing the emergence of resistance, decreasing healthcare costs, and preventing drug-related adverse events while improving patients' clinical outcomes.
Objectives: To determine the antimicrobial stewardship programme's impact using a prospective audit with feedback on antimicrobial prescribing practices in a Paediatrics department.
Methods: A baseline Point prevalence survey and post-intervention Point prevalence survey (PPS) were conducted in April 2019 and November 2019, respectively, in the Department of Paediatrics of the Lagos University Teaching Hospital (LUTH) using the global point prevalence survey (Global-PPS) of antimicrobial consumption and resistance as a tool. We compared the results from the two surveys to determine their impact on antibiotic prescribing practices in the department.
Results: At baseline PPS, 90 of 114 children (78.9%) were treated with 164 antibiotics. At post-intervention PPS, 46 out of 62 children (74.2%) were on 81 antibiotics. The antimicrobial consumption rate decreased from 79% to 74% pre- and post-intervention. The reason for antibiotic therapy documentation increased from 99.5% to 100% post-intervention. Guideline compliance increased from 43.1% to 76.5%. Stop/review date documentation increased from 42.5% to 81.5% post-intervention. Targeted therapy moved from 7.9% to 25.9%. Treatment based on biomarkers improved from 4.27% to 60.5%. ASP significantly enhanced the quality indicators {χ2:13.998; P=0.01}.
Conclusion: Antimicrobial Stewardship Programmes optimised antibiotic use through coordinated interventions. Point Prevalence Surveys (PPS) identify areas for improvement, and the Global PPS has proven to be an effective tool in detecting opportunities for enhancement.
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