A STUDY ON FREQUENCY OF ANTIBIOTIC DE-ESCALATION PRACTICES AND IMPLEMENTATION OF ANTIMICROBIAL STEWARDSHIP PROGRAMMES IN A TERTIARY CARE HOSPITAL

Abstract

Introduction: De-escalation of empirical antibiotic therapy is an essential part of antimicrobial stewardship programmes. It involves streamlining antibiotics to lower broad-spectrum antibiotic exposure based on microbiological cultures. This leads to effective targeting of the causative pathogen and at the same time, reduce the development of resistant microorganisms. As antibiotic-resistant microorganisms have become a clinical challenge in both inpatient and outpatient settings, such practices are increasingly employed in healthcare settings. Aim: The study aims to promote and measure the use of an appropriate agent, dose, duration, and route of administration of antimicrobial agents in order to improve patient outcomes while minimizing adverse events, including toxicity. Methods:Aprospective observational study was conducted in a tertiary care hospital. The sample size was 500 patients. The study was performed from October 2019 to September 2020. The participant's details were collected from patient medical records. The data obtained was analysed with MS Excel and the study results were expressed in number and percentages. Results and discussion: The number of blood samples and cultures obtained during the study period was noted. In our study, the percentage of single antibiotic prescriptions was highest in July 2020 (68.75%) as compared to other months while multiple antibiotic prescriptions were highest in January 2020 (82.75%). The number of antibiotics continued after obtaining the culture report was highest in February (30) while the highest percentage was seen in August 2020 (89.65%). The percentage appropriate de-escalation was highest in the month of April (82.35%) while September saw the highest number of multiple antibiotic prescriptions (25). Conclusion: The present study revealed positive results towards antibiotic de-escalating practices in the clinical settings to improve patient outcomes and reduce the use of antimicrobials which, in turn, can contribute to slowing down the further development of antibiotic resistance in hospitals.