Original Research

Impact of an antibiotic stewardship programme in a surgical setting

Muhammad A. Bashar, Jacqui Miot, Evan Shoul, Robyn L. van Zyl
Southern African Journal of Infectious Diseases | Vol 36, No 1 | a307 | DOI: https://doi.org/10.4102/sajid.v36i1.307 | © 2021 Muhammad A. Bashar, Jacqui Miot, Evan Shoul, Robyn L. van Zyl | This work is licensed under CC Attribution 4.0
Submitted: 07 June 2021 | Published: 24 November 2021

About the author(s)

Muhammad A. Bashar, Pharmacology Division, Department of Pharmacy and Pharmacology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; and, Department of Pharmacology and Therapeutics, College of Health Sciences, Federal University Birnin Kebbi, Birnin Kebb, Nigeria
Jacqui Miot, Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Evan Shoul, Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Robyn L. van Zyl, Pharmacology Division, Department of Pharmacy and Pharmacology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa


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Abstract

Background: Antibiotics are miracles of science and critical for many surgical procedures. However, the emergence of multidrug resistant pathogens resulting from inappropriate antibiotic use is a threat to modern medicine. This study aimed to determine the appropriateness of antibiotic use, cost, consumption and impact of an antibiotic stewardship intervention round in a surgical ward setting.

Methods: Baseline antibiotic utilisation was determined with a retrospective cross-sectional study in two surgical wards in a tertiary academic hospital in South Africa where medical records of 264 patients who received antibiotics were reviewed. In the second stage of the study, records of 212 patients who received antibiotics were reviewed during a weekly antibiotic stewardship intervention round. The volume of antibiotics consumed was determined using defined daily doses (DDDs)/1000 patients’ days, and the appropriateness of the antibiotic prescription for treatment was also determined using a quality-of-use algorithm.

Results: There was a reduction in the volume of antibiotic consumption from a total 739.30 DDDs/1000 to 564.93 DDDs/1000 patient days, with reduction in inappropriate antibiotic use from 35% to 26% from baseline to antibiotic stewardship programme stages, respectively. There was an overall increase in culture targeted therapy in both wards in the antibiotic stewardship programme stage.

Conclusion: The implementation of an antibiotic stewardship programme led to a reduction in antibiotic consumption and improvement in appropriate use of antibiotics.


Keywords

antibiotic; antibiotic resistance; antibiotic stewardship; surgery; South Africa; antibiotic prophylaxis; surgical site infection; antibiotic usage

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