Attar Neelam R, Dhanawade Sara S, Yadav Divya, Nikam Jalandhar
Microbiology, Bharati Vidyapeeth (Deemed to be University) Medical College & Hospital, Sangli, IND.
Paediatrics and Child Health, Bharati Vidyapeeth (Deemed to be University) Medical College & Hospital, Sangli, IND.
Cureus. 2025 Mar 4;17(3):e80012. doi: 10.7759/cureus.80012. eCollection 2025 Mar.
Non-judicious use of antibiotics by health professionals has been identified as an area for interventions and improvement by the World Health Organization for controlling antimicrobial resistance. Following the Indian Council for Medical Research (ICMR) guidelines, we established an antimicrobial stewardship (AMS) program at the 950-bedded multispecialty private sector hospital located in western Maharashtra by the end of the year 2021.
The purpose of this study was to evaluate the impact of an AMS program intervention on the utilization of antibiotics and resistance patterns of organisms isolated from the patients.
A significant reduction in the utilization of ceftriaxone (23.3 to 6.75), piperacillin-tazobactam (7.7 to 6.0), amikacin (9.03 to 5.15), clindamycin (6.25 to 5.75), linezolid (5.8 to 4.8), and ceftazidime (0.9 to 0.2) in defined daily doses (DDD/100 bed days) was seen after intervention. Antibiotic resistance decreased in gentamicin, amikacin, and teicoplanin. Overall antibiotic consumption reduced from 1,681.0 to 1,420.0 DDD/100 days. Culture-based therapy increased from 61% to 90%. Surgical prophylaxis compliance increased from 58% to 96%.
The constant perseverance of the AMS team of our hospital had a positive impact on reducing the overall consumption of antibiotics. Stringent infection prevention and control practices, timely provision of treatment guidelines, frequent interactions and discussions with treating doctors, audits by clinical pharmacists, and feedback to the doctors along with various training programs and sensitization sessions by the AMS team have brought significant behavioral changes among the treating physicians.
世界卫生组织已将卫生专业人员不合理使用抗生素确定为控制抗菌药物耐药性的干预和改进领域。根据印度医学研究理事会（ICMR）的指南，我们于2021年底在位于马哈拉施特拉邦西部的一家拥有950张床位的多专科私立医院建立了抗菌药物管理（AMS）项目。
本研究的目的是评估AMS项目干预对患者抗生素使用情况及分离出的生物体耐药模式的影响。
干预后，头孢曲松（从23.3降至6.75）、哌拉西林-他唑巴坦（从7.7降至6.0）、阿米卡星（从9.03降至5.15）、克林霉素（从6.25降至5.75）、利奈唑胺（从5.8降至4.8）和头孢他啶（从0.9降至0.2）的限定日剂量（DDD/100床日）使用量显著减少。庆大霉素、阿米卡星和替考拉宁的抗生素耐药性降低。总体抗生素消耗量从1681.0 DDD/100天降至1420.0 DDD/100天。基于培养的治疗从61%增加到90%。手术预防依从性从58%增加到96%。
我院AMS团队的持续坚持对减少抗生素总体使用量产生了积极影响。严格的感染预防和控制措施、及时提供治疗指南、与主治医生频繁互动和讨论、临床药师进行审核、向医生反馈以及AMS团队开展的各种培训项目和宣传活动，已使主治医生的行为发生了显著变化。
