Implementation and Practice of the Antimicrobial Stewardship Program (ASP) in Various Healthcare Settings in Al Ahsa

Lorina Badger-Emeka, Promise Emeka, Sayed Quadri, Hussein AlHelal, Abdulrahim Alabdulsalam, Mohammed Buhalim, Omer Alrasheed and Muktar AlHelal

Background and Objective: The threat of post-antibiotic-era challenges has created concern globally, leading to various education interventions aimed at controlling factors that influence the prescription and administration of antibiotics through policy formulation. The global institution of antimicrobial stewardship program (ASP) is to curtail antibiotic resistance and improve patient outcomes. The study looks at the extent of ASP implementation and practice in various fields of healthcare facilities since the inception of the program. Materials and Methods: A validated questionnaire with forty-one questions of ASP core elements, grouped into ten sections, developed with Google forms, was distributed online to physicians, pharmacists and nurses in hospital-based institutions within Al Ahsa. The questionnaire consisted of 10 segments of 41 questions, grouped into demography, familiarity with antimicrobial resistance and the antimicrobial stewardship program, leadership commitment, program commitment and pharmacist expertise amongst other questions. Data was analyzed using SPSS version 26 and GraphPad Prism 10 software. Significance was statistically taken as p<0.05. Results: There is increased knowledge on the seriousness of antimicrobial resistance in Saudi Arabia (94.8%) and various healthcare facilities (89.1%). Leadership commitment (49.1%), conducting daily reviews of antibiotics for treatment duration on definitive diagnosis (46.4%) and patient discharge with correct antibiotics and recommended duration (32.7%) were inadequate. The implementation level of the program performance (38.2%) in planned Outpatient Parental Antibiotic Therapy (OPAT) as well as tracking of antibiotic resistance by submissions to AMR and ASP (40.9%) was low. Conclusion: Nine years after ASP was inaugurated, we can conclude that awareness is good, but implementation of core elements of the program is low, thus requiring commitment to improve at every level of its operation.

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