Evaluation of the Application of Antimicrobial Stewardship on the Rational Use of Antibiotics and Overcoming Antimicrobial Resistance in Tertiary Hospitals: A Point Prevalence Survey

Document Type

Article

Publication Date

1-2026

Abstract

Purpose

Multidrug-resistant (MDR) microorganisms has emerged as a significant global health crisis leading to higher rates of morbidity. Antimicrobial resistance (AMR) presents a serious challenge in intensive care units (ICUs), where infections caused by MDR pathogens are common. Thus, implementation of antimicrobial stewardship programs (ASPs) ensures prudent antibiotic use and decreases AMR. Therefore, the current study evaluates the impact of ASP applications on empirical antibiotic prescribing practices and AMR through a Point Prevalence Survey (PPS) in ICU settings.

Methods

A prospective, multicentric, quasi-experimental study was conducted in various departments over a period of 12 weeks. Inpatients receiving antibiotics were surveyed before and after the implementation of ASP. These interventions included customizing ASP guidelines, training healthcare team, and auditing prescribing behaviors. Data was analyzed using SPSS, and outcomes evaluated included adherence to guidelines, prevalence of antibiotic use, and appropriateness of prescriptions.

Results

Of the 174 patients were surveyed across PPS. Escherichia coli showed the highest prevalence in PPS-1 (26%), while Klebsiella pneumoniae and Staphylococcus aureus showed the highest in PPS-2 (18%). Carbapenem-resistant Enterobacteriaceae decreased from 25% in PPS-1 to 8% in PPS-2. Guideline-inappropriate prescriptions and missing documentation of preparation or administration method declined from 27.3% to 5.2% (P = 0.000042) and from 78.5% to 56.2% (P = 0.002) respectively, reflecting improved prescribing quality and record-keeping. Although the proportion of prescriptions with improper antibiotic duration increased from 32.1% to 42.7% (P= 0.145), this trend may reflect evolving clinical decision-making rather than a decline in care quality.

Conclusion

The study suggests that ASP interventions were associated with improved antibiotic prescribing practices and adherence to guidelines in ICU settings, contributing to the fight against AMR. Given the study design and sample size, findings are exploratory and suggestive. Future work includes expanding ASP monitoring and education strategies with solutions focusing on antibiotic duration.

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