1002. Global Impact Of An Antimicrobial Stewardship Program At A 430 Bedded Tertiary Care Hospital In The United Arab Emirates (UAE)
Session: Poster Abstract Session: Stewardship: Implementing Programs
Friday, October 4, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • IDSA Poster1.pdf (536.6 kB)
  • Background: There is a lack of antibiotic stewardship programs in the UAE and unrestricted antimicrobial prescription is the norm. Baseline audits conducted in 2007 showed overuse of carbapenems, third generation cephalosporins and the fluoroquinolones at Tawam Hospital. We implemented an antimicrobial stewardship program at our hospital in 2008 based on IDSA/SHEA guidelines in an attempt to decrease use of these antibiotics. 

    Methods:    The stewardship team comprised ID consultants, clinical pharmacist and clinical microbiologist with Information Technology (IT) and quality office support. The program employed formulary restriction, antibiotic use guidelines, computer-based antimicrobial management, formal scheduled rounds in high-risk units and one-on-one physician education. Monthly audit of antimicrobial use was based on DDD/1000 inpatient days. 

    Results: The program has achieved remarkable success in reducing the use of the targeted antibiotic groups. Carbapenem use fell by 57.7% (107.8 to 45.6 DDD/1000 inpatient days, 3rd and 4th generation cephalosporin use by 74.8% (104.6 to 26.4 DDD/1000 inpatient days) and fluoroquinolone use by 90.5% (70.2 to 6.7 DDD/1000 inpatient days). Interestingly, use of drugs not targeted specifically by the program, like anti-MRSA agent (vancomycin), also fell by 57% (26.8 to 12.5 DDD/1000 inpatient days). Overall antibiotic consumption in the inpatient setting fell from a peak of 515.3 DDD/1000 inpatient days in 2009 to 235.4 DDD/1000 inpatient days in 2012, a reduction of 54%. ASP activities saved the hospital in excess of AED 4,000,000 (1.1 million USD)/year in direct drug costs alone. There was no change severity of illness as measured by case mix index (CMI) during the study period.

    Conclusion: In the first program of its kind in the UAE, the implementation of antimicrobial stewardship strategies resulted in a progressive and sustained decrease in the use of targeted and non-targeted antibiotics, achieving a global reduction of 54% in inpatient antibiotic use. This impact is highter than similar programs previously reported in the literature suggesting a high level of inappropriate use at baseline.

    Rayhan Hashmey, MBBS1, Asad Khan, MBBS1, Aqeel Saleem, MBBS1, Kholoud Jamal2, Dalal Mansouri1 and Yousuf Naqvi, MBBS3, (1)Medicine, Tawam Hospital, Al Ain, United Arab Emirates, (2)Pharmacy, Tawam Hospital, Al Ain, United Arab Emirates, (3)Health Regulation Division, Health Aurthority of Abu Dhabi, Abu Dhabi, United Arab Emirates

    Disclosures:

    R. Hashmey, None

    A. Khan, None

    A. Saleem, None

    K. Jamal, None

    D. Mansouri, None

    Y. Naqvi, None

    Findings in the abstracts are embargoed until 12:01 a.m. PST, Oct. 2nd with the exception of research findings presented at the IDWeek press conferences.