Impact of antimicrobial stewardship program in the paediatric department of a tertiary health facility in Nigeria

Abstract

Background: Antimicrobial resistance is a major issue limiting the successful treatment of infectious diseases. Development of antimicrobial resistance can be curbed by the adoption of antimicrobial stewardship programs which aims to optimize the use of antimicrobial agents and combat antimicrobial resistance. The study aimed to evaluate the impact of antimicrobial stewardship program implemented in the paediatric department of a tertiary healthcare facility.

Methods: This was a retrospective, cross-sectional study before and after the introduction of an antimicrobial stewardship program. A  Global-point prevalence survey was conducted in 2017 to determine the baseline prescription practices. Based on the results, an  antimicrobial stewardship program was developed. A second Global-point prevalence survey was conducted in 2018. The impact of the  antimicrobial stewardship interventions was evaluated.

Results: An 8.1% reduction in antimicrobials prescribed, an 18% increase in  targeted therapy and increased use of biomarkers in the institution of therapy were observed. There was an 8.2% reduction in parenteral  therapy. Compliance with the antibiotic guideline was 67.8%. Utilization of the medical microbiology laboratory increased. An increase in  the detection of multidrugresistant organisms was observed. The majority of the antimicrobials prescribed were in the Access group of  the AWaRe classiication of antibiotics by WHO.

Conclusion: This study demonstrated an improvement in antimicrobial prescribing  practices due to the implementation of an antimicrobial stewardship program. This study contributes to the growing body of evidence  supporting the effectiveness of antimicrobial stewardship programs. Sustained practice of antimicrobial stewardship will improve  antimicrobial prescription patterns thus controlling the development of antimicrobial resistance in healthcare facilities.