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Impact of Antimicrobial Stewardship program on Hospitalized Patients at the Intensive Care Unit: A prospective Audit and feedback Study

Authors

Maher R. Khdour* 1 Associate Professor of Pharmacotherapy, Faculty of Pharmacy, Al-Quds University, Abu Deis, PO Box 20002, West Bank, Palestine. maher.khdour@

Hussein O. Hallak2 Associate Professor of Pharmacology, Faculty of Pharmacy, Al-Quds University, Abu Deis, PO Box 20002, West Bank, Palestine. E-mail husseinhallak@

Mamoon Al-Deyab3 Assistant Prof. in Clinical Pharmacy, School of Pharmacy and Pharmaceutical Sciences, University of Ulster, Coleraine, county Londonderry, UK. M.aldeyab@ulster.ac.uk

Mowafq A. Nasif4 Head of Intensive Care Department at Palestinian Medical Complex, Baladiya St. 00972. Ramallah, West Bank, Palestine nasif43@

Aliaa M. Khalili5 Internal Medicine Resident at Palestinian Medical Complex, Baladiya St. 00972. Ramallah, West Bank, Palestine, Aliaa.khalili@

Ahamad A. Dallashi6 Internal Medicine Resident at Palestinian Medical Complex, Baladiya St. 00972. Ramallah, West Bank, Palestine. ahmaddalashi@

Mohammad B. Khofash7 Clinical Pharmacist at Palestinian Medical Complex, Baladiya St. 00972. Ramallah, Palestine. mkhafash9@

Michael G Scott8

Pharmacy and Medicines Management Centre, Antrim Area Hospital, BT41 2RL

Northern Ireland. DrMichael.Scott@northerntrust.

*Correspondence: Maher Khdour, Associate Professor of Pharmacotherapy, Faculty of Pharmacy, Al-Quds University, Abu Deis, PO Box 20002, Jerusalem, Palestine.

E-mail: mkhdour@pharm.alquds.edu or maher.khdour@

Keywords: Antimicrobials, Stewardship, ICU, Antibiotic Utilization

Running Head: Antimicrobial Stewardship in the ICU

Word count: 2600 Figures: 1 Tables: 3

Aims: Inappropriate use of antibiotics is one of the most important factors contributing to the emergence of drug resistant pathogens. The purpose of this study was to measure the clinical impact of Antimicrobial Stewardship Program (ASP) interventions on hospitalized patients at the Intensive care unit at Palestinian Medical Complex.

Methods: A prospective audit with intervention and feedback by ASP team within 48-72h of antibiotic administration began in Sep, 2015. Four months of pre-ASP data with 4-months of post-ASP data were compared. Data collected included clinical and demographic data; utilization of antimicrobials measured by Define Daily Doses, duration of therapy, length of stay, readmission and all-cause mortality.

Results: Overall, 176 interventions were made the ASP team with an average acceptance rate of 78.4%. The most accepted interventions were dose optimization (87.0%) followed by de-escalation based on culture results with an acceptance rate of 84.4%. ASP interventions significantly reduces antimicrobial utilization by 24.3% (87.3 DDD/100 bed. vs 66.1 DDD/100 bed p ................
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