Prescribing patterns of carbapenem and the acceptance of a carbapenem antimicrobial stewardship program in a tertiary teaching hospital in Malaysia

Background: Proton-pump inhibitor (PPI) is a widely used medication class globally. Because of its good safety profile, there is a huge likelihood of inappropriate use. Objectives: To determine the prevalence of PPI use and indications, describe its pattern of usage, and identify factors associated with inappropriate prescriptions at a federal tertiary teaching hospital in Maiduguri, Nigeria. Methods: PPI prescriptions were retrospectively assessed in the General Outpatients’ Department (GOPD) and Gastroenterology Unit (GITU) of a teaching hospital. Relevant data for the study were extracted from the patients’ medical records. Chi-square or Fisher’s exact tests where appropriate were used to identify factors associated with inappropriate PPI prescriptions. A p < 0.05 was considered to be significant. Results: PPIs were prescribed to 73.3% (220/300) of patients, while inappropriate prescriptions were noted in 91.4% (201/220) of these patients. Epigastric pain (49.5%) was the most common PPI indication, while omeprazole was the highest prescribed (53.4%). Nearly all inpatients (98.2%), those with epigastric pain (95.7%), and patients who were prescribed intravenous PPIs had more inappropriate PPI prescriptions compared to others. Conclusion: This study revealed a high prevalence of PPI use and inappropriate prescriptions at the study hospital. As a result, these findings highlight the importance PPI-based stewardship program at the study hospital.

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Impact of Antimicrobial Stewardship Program on Vancomycin Use in a Pediatric Teaching Hospital

The Pediatric Infectious Disease Journal ◽

10.1097/inf.0b013e3181d683f8 ◽

2010 ◽

Vol 29 (8) ◽

pp. 707-711 ◽

Cited By ~ 65

Author(s):

M. Cecilia Di Pentima ◽

Shannon Chan

Keyword(s):

Teaching Hospital ◽

Antimicrobial Stewardship ◽

Antimicrobial Stewardship Program ◽

Stewardship Program

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The positive effects of an antimicrobial stewardship program targeting outpatient hemodialysis facilities

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2018.237 ◽

2018 ◽

Vol 39 (12) ◽

pp. 1400-1405 ◽

Cited By ~ 9

Author(s):

Erika M. C. D’Agata ◽

Curt C. Lindberg ◽

Claire M. Lindberg ◽

Gemma Downham ◽

Brandi Esposito ◽

...

Keyword(s):

Antimicrobial Stewardship ◽

Interrupted Time Series ◽

Multidrug Resistant ◽

Prescribing Patterns ◽

Antimicrobial Stewardship Program ◽

Intervention Period ◽

Positive Effects ◽

Antimicrobial Prescribing ◽

Stewardship Program ◽

Dialysis Facilities

AbstractBackgroundAntimicrobial stewardship programs are effective in optimizing antimicrobial prescribing patterns and decreasing the negative outcomes of antimicrobial exposure, including the emergence of multidrug-resistant organisms. In dialysis facilities, 30%–35% of antimicrobials are either not indicated or the type of antimicrobial is not optimal. Although antimicrobial stewardship programs are now implemented nationwide in hospital settings, programs specific to the maintenance dialysis facilities have not been developed.ObjectiveTo quantify the effect of an antimicrobial stewardship program in reducing antimicrobial prescribing.Study design and settingAn interrupted time-series study in 6 outpatient hemodialysis facilities was conducted in which mean monthly antimicrobial doses per 100 patient months during the 12 months prior to the program were compared to those in the 12-month intervention period.ResultsImplementation of the antimicrobial stewardship program was associated with a 6% monthly reduction in antimicrobial doses per 100 patient months during the intervention period (P=.02). The initial mean of 22.6 antimicrobial doses per 100 patient months decreased to a mean of 10.5 antimicrobial doses per 100 patient months at the end of the intervention. There were no significant changes in antimicrobial use by type, including vancomycin. Antimicrobial adjustments were recommended for 30 of 145 antimicrobial courses (20.6%) for which there were sufficient clinical data. The most frequent reasons for adjustment included de-escalation from vancomycin to cefazolin for methicillin-susceptible Staphylococcus aureus infections and discontinuation of antimicrobials when criteria for presumed infection were not met.ConclusionsWithin 6 hemodialysis facilities, implementation of an antimicrobial stewardship was associated with a decline in antimicrobial prescribing with no negative effects.

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