ArticleJournal of pharmaceutical policy and practice2020
An antibiotic stewardship program in a surgical ICU of a resource-limited country: financial impact with improved clinical outcomes.
Article in Journal of pharmaceutical policy and practice, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
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Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it, 15 citations in OpenAlex.
- Interventions for improving critical care in low- and middle-income countries: a systematic review.Intensive care medicine · 2024Pooled it
- Pooled it
- Article
- Feasibility and Policy Implications of a Pragmatically Adapted Pediatric-Inspired Induction Regimen for Adults with Acute Lymphoblastic Leukemia in a Resource-Restricted Setting: A Prospective Observational Study.Healthcare (Basel, Switzerland) · 2026Article
- Evaluation of Antibiotic Use in Patients Admitted to a Hungarian Intensive Care Unit with Pneumonia and Sepsis: Retrospective Observational Before-After Study.Antibiotics (Basel, Switzerland) · 2026Article
- Antimicrobial stewardship interventions in the WHO Eastern Mediterranean Region Countries: a scoping review of clinical, economic, and consumption outcomes.Antimicrobial resistance and infection control · 2025Article
- Clinical impact of an antibiotic stewardship program in a neonatal intensive care unit at a tertiary care hospital: a prospective quasi-experimental clinical study.Journal of pharmaceutical health care and sciences · 2025Article
- Cost-benefit analysis of pharmacist early active consultation in patients with multidrug-resistant bacteria in China.International journal of clinical pharmacy · 2025Article
- Progress on the Global Research Agenda for Antimicrobial Resistance in Human Health in Pakistan: Findings and Implications.Infection and drug resistance · 2025Review
- Clinical pharmacist-led antifungal drug utilization reviews in cancer care hospital: a prospective audit and feedback.JAC-antimicrobial resistance · 2024Article
- Bacteriocins: potentials and prospects in health and agrifood systems.Archives of microbiology · 2024Review
- Barriers, facilitators, perceptions and impact of interventions in implementing antimicrobial stewardship programs in hospitals of low-middle and middle countries: a scoping review.Antimicrobial resistance and infection control · 2024Article
- Implementation of a hospital antimicrobial stewardship program to improve vancomycin use in Cyprus: Challenges and opportunity.Infection prevention in practice · 2022Article
- Discordance to ASHP Therapeutic Guidelines Increases the Risk of Surgical Site Infection.Pharmaceuticals (Basel, Switzerland) · 2021Article
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAntibiotic resistance (ABX-R) is alarming in lower/middle-income countries (LMICs). Nonadherence to antibiotic guidelines and inappropriate prescribing are significant contributing factors to ABX-R. This study determined the clinical and economic impacts of antibiotic stewardship program (ASP) in surgical intensive care units (SICU) of LMIC.
methodWe conducted this pre and post-test analysis in adult SICU of Aga Khan University Hospital, Pakistan, and compared pre-ASP (September-December 2017) and post-ASP data (April-July 2018). January-March 2018 as an implementation/training phase, for designing standard operating procedures and training the team. We enrolled all the patients admitted to adult SICU and prescribed any antibiotic. ASP-team daily reviewed antibiotics prescription for its appropriateness. Through prospective-audit and feedback-mechanism changes were made and recorded. Outcome measures included antibiotic defined daily dose (DDDs)/1000 patient-days, prescription appropriateness, antibiotic duration, readmission, mortality, and cost-effectiveness.
result123 and 125 patients were enrolled in pre-ASP and post-ASP periods. DDDs/1000 patient-days of all the antibiotics reduced in the post-ASP period, ceftriaxone, cefazolin, metronidazole, piperacillin/tazobactam, and vancomycin showed statistically significant (
conclusionASP implementation with supplemental efforts can improve the appropriateness of antibiotic prescriptions and the optimum duration of use. The approach is cost-effective mainly due to the reduced cost of antibiotics with rational use. Better source-control-documentation may further minimize the ABX-R in SICU.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.