Assessment of Adherence to the Core Elements of Hospital Antibiotic Stewardship Programs: A Survey of the Tertiary Care Hospitals in Punjab, Pakistan
<b>Background:</b> To restrain antibiotic resistance, the Centers for Disease Control and Prevention (CDC), United States of America, urges all hospital settings to implement the Core Elements of Hospital Antibiotic Stewardship Programs (CEHASP). However, the concept of hospital-based an...
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doaj-3196edd05936463788e26cc9d25a60242021-08-26T13:27:52ZengMDPI AGAntibiotics2079-63822021-07-011090690610.3390/antibiotics10080906Assessment of Adherence to the Core Elements of Hospital Antibiotic Stewardship Programs: A Survey of the Tertiary Care Hospitals in Punjab, PakistanNaeem Mubarak0Asma Sarwar Khan1Taheer Zahid2Umm e Barirah Ijaz3Muhammad Majid Aziz4Rabeel Khan5Khalid Mahmood6Nasira Saif-ur-Rehman7Che Suraya Zin8Department of Pharmacy Practice, Lahore Medical & Dental College, University of Health Sciences, Lahore 54600, PakistanDepartment of Pharmacy Practice, Lahore Medical & Dental College, University of Health Sciences, Lahore 54600, PakistanDepartment of Pharmacy Practice, Lahore Medical & Dental College, University of Health Sciences, Lahore 54600, PakistanDepartment of Pharmacy Practice, Lahore Medical & Dental College, University of Health Sciences, Lahore 54600, PakistanDepartment of Pharmacy Practice, Lahore Medical & Dental College, University of Health Sciences, Lahore 54600, PakistanDepartment of Pharmacy Practice, Lahore Medical & Dental College, University of Health Sciences, Lahore 54600, PakistanInstitute of Information Management, University of the Punjab, Lahore 54000, PakistanDepartment of Pharmacy Practice, Lahore Medical & Dental College, University of Health Sciences, Lahore 54600, PakistanKulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan 25200, Malaysia<b>Background:</b> To restrain antibiotic resistance, the Centers for Disease Control and Prevention (CDC), United States of America, urges all hospital settings to implement the Core Elements of Hospital Antibiotic Stewardship Programs (CEHASP). However, the concept of hospital-based antibiotic stewardship programs is relatively new in Low- and Middle-Income Countries. <b>Aim:</b> To appraise the adherence of the tertiary care hospitals to seven CEHASPs. <b>Design and Setting:</b> A cross-sectional study in the tertiary care hospitals in Punjab, Pakistan. <b>Method:</b> CEHASP assessment tool, (a checklist) was used to collect data from the eligible hospitals based on purposive sampling. The check list had 19 statements to cover seven CEHASPs: <i>Hospital Leadership Commitment, Accountability, Pharmacy Expertise, Action (Implement Interventions to Improve Antibiotic Use), Tracking Antibiotic Use and Outcomes, Reporting Antibiotic Use and Outcomes,</i> and <i>Education.</i> For each statement, a response of “YES”, “NO” or “Under Process” constituted a score of 2, 0 and 1, respectively, where the higher the scores the better the adherence. Categorical variables were described through descriptive statistics, while independent <i>t</i>-test computed group differences. <b>Result</b>: A total of 68 hospitals (<i>n</i> = 33 public, <i>n</i> = 35 private) participated with a response rate of 79.1%. No hospital demonstrated “Perfect” adherence. Roughly half private (48.6%) and more than half public (54.5%) sector hospitals were “Poor“ in adherence. Based on the mean score, there was no significant difference between the private and the public hospitals in terms of comparison of individual core elements. The two most neglected core elements emerged as top priority area were: <i>Reporting Antibiotic Use and Outcomes and Tracking Antibiotic Use and Outcomes.</i><b>Conclusion:</b> The current response of Pakistan to implement hospital-based antibiotic stewardship programs is inadequate. This study points out significant gaps of practice both in public and private tertiary care hospitals. A majority of the core elements of antibiotic stewardship are either absent or ”Under Process”. The deficiency/priority areas mentioned require immediate attention of the concerned stakeholders in Pakistan.https://www.mdpi.com/2079-6382/10/8/906antibiotic stewardshipantimicrobial stewardshiphospitalstertiary carePakistancore elements |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Naeem Mubarak Asma Sarwar Khan Taheer Zahid Umm e Barirah Ijaz Muhammad Majid Aziz Rabeel Khan Khalid Mahmood Nasira Saif-ur-Rehman Che Suraya Zin |
spellingShingle |
Naeem Mubarak Asma Sarwar Khan Taheer Zahid Umm e Barirah Ijaz Muhammad Majid Aziz Rabeel Khan Khalid Mahmood Nasira Saif-ur-Rehman Che Suraya Zin Assessment of Adherence to the Core Elements of Hospital Antibiotic Stewardship Programs: A Survey of the Tertiary Care Hospitals in Punjab, Pakistan Antibiotics antibiotic stewardship antimicrobial stewardship hospitals tertiary care Pakistan core elements |
author_facet |
Naeem Mubarak Asma Sarwar Khan Taheer Zahid Umm e Barirah Ijaz Muhammad Majid Aziz Rabeel Khan Khalid Mahmood Nasira Saif-ur-Rehman Che Suraya Zin |
author_sort |
Naeem Mubarak |
title |
Assessment of Adherence to the Core Elements of Hospital Antibiotic Stewardship Programs: A Survey of the Tertiary Care Hospitals in Punjab, Pakistan |
title_short |
Assessment of Adherence to the Core Elements of Hospital Antibiotic Stewardship Programs: A Survey of the Tertiary Care Hospitals in Punjab, Pakistan |
title_full |
Assessment of Adherence to the Core Elements of Hospital Antibiotic Stewardship Programs: A Survey of the Tertiary Care Hospitals in Punjab, Pakistan |
title_fullStr |
Assessment of Adherence to the Core Elements of Hospital Antibiotic Stewardship Programs: A Survey of the Tertiary Care Hospitals in Punjab, Pakistan |
title_full_unstemmed |
Assessment of Adherence to the Core Elements of Hospital Antibiotic Stewardship Programs: A Survey of the Tertiary Care Hospitals in Punjab, Pakistan |
title_sort |
assessment of adherence to the core elements of hospital antibiotic stewardship programs: a survey of the tertiary care hospitals in punjab, pakistan |
publisher |
MDPI AG |
series |
Antibiotics |
issn |
2079-6382 |
publishDate |
2021-07-01 |
description |
<b>Background:</b> To restrain antibiotic resistance, the Centers for Disease Control and Prevention (CDC), United States of America, urges all hospital settings to implement the Core Elements of Hospital Antibiotic Stewardship Programs (CEHASP). However, the concept of hospital-based antibiotic stewardship programs is relatively new in Low- and Middle-Income Countries. <b>Aim:</b> To appraise the adherence of the tertiary care hospitals to seven CEHASPs. <b>Design and Setting:</b> A cross-sectional study in the tertiary care hospitals in Punjab, Pakistan. <b>Method:</b> CEHASP assessment tool, (a checklist) was used to collect data from the eligible hospitals based on purposive sampling. The check list had 19 statements to cover seven CEHASPs: <i>Hospital Leadership Commitment, Accountability, Pharmacy Expertise, Action (Implement Interventions to Improve Antibiotic Use), Tracking Antibiotic Use and Outcomes, Reporting Antibiotic Use and Outcomes,</i> and <i>Education.</i> For each statement, a response of “YES”, “NO” or “Under Process” constituted a score of 2, 0 and 1, respectively, where the higher the scores the better the adherence. Categorical variables were described through descriptive statistics, while independent <i>t</i>-test computed group differences. <b>Result</b>: A total of 68 hospitals (<i>n</i> = 33 public, <i>n</i> = 35 private) participated with a response rate of 79.1%. No hospital demonstrated “Perfect” adherence. Roughly half private (48.6%) and more than half public (54.5%) sector hospitals were “Poor“ in adherence. Based on the mean score, there was no significant difference between the private and the public hospitals in terms of comparison of individual core elements. The two most neglected core elements emerged as top priority area were: <i>Reporting Antibiotic Use and Outcomes and Tracking Antibiotic Use and Outcomes.</i><b>Conclusion:</b> The current response of Pakistan to implement hospital-based antibiotic stewardship programs is inadequate. This study points out significant gaps of practice both in public and private tertiary care hospitals. A majority of the core elements of antibiotic stewardship are either absent or ”Under Process”. The deficiency/priority areas mentioned require immediate attention of the concerned stakeholders in Pakistan. |
topic |
antibiotic stewardship antimicrobial stewardship hospitals tertiary care Pakistan core elements |
url |
https://www.mdpi.com/2079-6382/10/8/906 |
work_keys_str_mv |
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