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. 2021 Mar 9;10(3):280.
doi: 10.3390/antibiotics10030280.

Antimicrobial Stewardship Program Implementation in a Saudi Medical City: An Exploratory Case Study

Saleh Alghamdi  1 , Ilhem Berrou  2 , Eshtyag Bajnaid  3 , Zoe Aslanpour  4 , Abdul Haseeb  5 , Mohamed Anwar Hammad  1 , Nada Shebl  4
Affiliations

Antimicrobial Stewardship Program Implementation in a Saudi Medical City: An Exploratory Case Study

Saleh Alghamdi et al. Antibiotics (Basel). .

Abstract

Antimicrobial stewardship programs (ASPs) in hospitals have long been shown to improve antimicrobials' use and reduce the rates of antimicrobial resistance. However, their implementation in hospitals, especially in developing countries such as Saudi Arabia, remains low. One of the main barriers to implementation is the lack of knowledge of how to implement them. This study aims to explore how an antimicrobial stewardship programme was implemented in a Saudi hospital, the challenges faced and how they were overcome, and the program outcomes. A key stakeholder case study design was used, involving in-depth semi-structured interviews with the core members of the ASP team and analysis of 35 ASP hospital documents. ASP implementation followed a top-down approach and involved an initial preparatory phase and an implementation phase, requiring substantial infectious diseases and clinical pharmacy input throughout. Top management support was key to the successful implementation. ASP implementation reduced rates of multi-drug resistance and prescription of broad-spectrum antimicrobials. The implementation of ASPs in hospital is administrator rather than clinician driven. Outsourcing expertise and resources may help hospitals address the initial implementation challenges.

Keywords: antimicrobial stewardship programs; hospitals; multi-drug resistance.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Patient safety portfolio of programs.
Figure 2
Figure 2
Roles and responsibilities of core members of the ASP team. ASP (antimicrobial stewardship programme); ID (Infectious Diseases); DOT (Days of Therapy).
Figure 3
Figure 3
The timeline for implementing the ASP in the medical city.
Figure 4
Figure 4
ASP implementation process model.
See this image and copyright information in PMC

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