Antimicrobial stewardship program (ASP): an effective implementing technique for the therapy efficiency of meropenem and vancomycin antibiotics in Iranian pediatric patients

Aliakbar Rahbarimanesh,Mohammad Kaji Yazdi,Anahita Izadi,Payman Sadeghi,Sayed Yousef Mojtahedi,Leila Khedmat,Maryam Ghodsi,Sara Kianfar,Saeedreza Jamali Moghadam Siyahkali

doi:10.1186/s12941-019-0305-1

Abstract

BackgroundAntimicrobial stewardship program (ASP) is a distinguished method to improve the prescription and efficacy of antibiotics.AimThe efficacy of ASP and conventional methods was compared to measure the effectiveness of meropenem (MPM) and vancomycin (VMN) antibiotics in pediatric patients.DesignIn an interventional quasi-experimental study, 135 children admitted in Children’s Hospital affiliated to University of Medical Sciences in time periods of 2014–2015 and 2015–2016 were assessed.MethodsThe conventional and ASP methods in 2014–2015 and 2015–2016 were respectively utilized to provide the best antimicrobial therapy of MPM and VMN antibiotics in patient children. The data of mortality rate (MR), antibiotic prescription (AP), antibiotic dose (ADe), antibiotic duration (ADn), length of hospital stay (LOHS), and blood cultures (BCs) were compared across the years using the Chi square, independent t test, and Fisher’s exact test.ResultsThe levels of MR, AP, ADe, ADn, LOHS, and positive BCs using the ASP method in 2015–2016 were significantly lower those of in 2014–2015 using the conventional one (p < 0.05).ConclusionsThe ASP method versus conventional one with a better efficacy can be employed as an antibiotic administration guide for MPM and VMN in the therapy of patients in community-based hospitals.

Highlights

Antimicrobial stewardship program (ASP) is a distinguished method to improve the prescription and efficacy of antibiotics
The ASP method versus conventional one with a better efficacy can be employed as an antibiotic administration guide for MPM and VMN in the therapy of patients in community-based hospitals
The outcomes of ASP and conventional method to control the antibiotic use of MPM and VMN in healthcare settings were compared in a community-based referral hospital in a developing country

Summary

Introduction

Antimicrobial stewardship program (ASP) is a distinguished method to improve the prescription and efficacy of antibiotics. The last one is an optimal use of antibiotics including true antimicrobial drug with an appropriate antibiotic dose (ADe), and duration (ADn) [9,10,11] This program was initially introduced in 1996 [12,13,14] aiming to the improvement in health care quality with better use of antibiotics, and subsequently the reduction of antibiotic resistance rate and health care costs [6, 15,16,17]. Implication of this method and assessment of its practical outcomes are essential to establish a comprehensive guideline for patients’ healthcare with a minimized toxicity and bacterial resistance [18]

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Discussion

Conclusion