ArticleGMS infectious diseases2025
Impact of an antimicrobial stewardship program on colistin resistance in a tertiary care hospital in Pakistan: a quasi-experimental study.
Article in GMS infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Colistin is a last-resort antibiotic used against infections caused by multidrug-resistant gram-negative organisms, particularly carbapenem-resistant strains. Rising resistance to colistin is a significant global concern. To address this, an Antimicrobial Stewardship (AMS) Program was introduced in our hospital, including pre-authorization protocols for colistin use. Objective: To evaluate the prevalence of colistin-resistant organisms and determine the impact of AMS implementation on their occurrence and associated clinical outcomes. Methods: We conducted a quasi-experimental study at a tertiary care hospital in Pakistan, comparing data from 18 months before and after AMS implementation. Adult patients (>18 years) with confirmed infections due to colistin-resistant Results: A total of 121 patients met inclusion criteria, with 45 (37.2%) in the pre-AMS period and 76 (62.8%) in the post-AMS period. Conclusion: While the AMS facilitated better identification and documentation of colistin-resistant infections, it did not significantly reduce their prevalence or associated mortality. Strengthened stewardship measures, continuous compliance monitoring, and alternative therapeutic strategies are needed to curb rising colistin resistance in high-burden settings.
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