Academic Journal
Impact of a clinical engagement targeted antimicrobial stewardship program on antimicrobial use in Pakistan: a multicenter longitudinal point prevalence survey.
| Τίτλος: | Impact of a clinical engagement targeted antimicrobial stewardship program on antimicrobial use in Pakistan: a multicenter longitudinal point prevalence survey. |
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| Συγγραφείς: | Mustafa T; Fleming Fund Country Grant, DAI, Blue Area, Islamabad, Pakistan., Akhtar H; School of Public Health, Health Services Academy, Islamabad, Pakistan., Ahsan Q; Fleming Fund Country Grant, DAI, Blue Area, Islamabad, Pakistan., Shaikh BT; School of Public Health, Health Services Academy, Islamabad, Pakistan., Ahmed S; Department of Biological Sciences, Faculty of Sciences, International Islamic University Islamabad, Islamabad, Pakistan., Ashraf M; School of Public Health, Health Services Academy, Islamabad, Pakistan., Akhtar TM; School of Public Health, Health Services Academy, Islamabad, Pakistan., Ahmed N; Department of Pharmacy, Quaid-i-Azam University, Islamabad, Pakistan., Khan SA; School of Public Health, Health Services Academy, Islamabad, Pakistan. |
| Πηγή: | Expert review of anti-infective therapy [Expert Rev Anti Infect Ther] 2026 Sep; Vol. 24 (9), pp. 877-889. Date of Electronic Publication: 2026 Jul 12. |
| Τύπος έκδοσης: | Journal Article; Multicenter Study |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Taylor & Francis Country of Publication: England NLM ID: 101181284 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1744-8336 (Electronic) Linking ISSN: 14787210 NLM ISO Abbreviation: Expert Rev Anti Infect Ther Subsets: MEDLINE |
| Imprint Name(s): | Publication: 2015- : Abingdon, Oxford : Taylor & Francis Original Publication: London : Future Drugs Ltd. |
| Ιατρικοί όροι (MeSH): | Antimicrobial Stewardship*/organization & administration , Antimicrobial Stewardship*/methods , Anti-Bacterial Agents*/administration & dosage , Practice Patterns, Physicians'*/statistics & numerical data , Practice Patterns, Physicians'*/standards, Guideline Adherence/statistics & numerical data ; Humans ; Pakistan ; Longitudinal Studies ; Hospitals, Public ; Practice Guidelines as Topic ; Prevalence ; Surveys and Questionnaires ; Drug Resistance, Bacterial ; Female ; Male ; Tertiary Care Centers |
| Περίληψη: | Background: Antimicrobial resistance is driven by excessive antibiotic use in hospitals, but evidence on the long-term effectiveness of antimicrobial stewardship interventions in public-sector hospitals in Pakistan is limited. We evaluated the impact of a structured clinical engagement AMS intervention affected antibiotic prescribing and stewardship in Pakistani public hospitals. Methods: A multicenter longitudinal study was conducted using serial WHO-standardized point prevalence surveys at baseline (February - March 2021), midline (July - August 2022), and endline (September - October 2023) across tertiary care public hospitals. Outcomes included antibiotic prescribing prevalence, guideline compliance, WHO AWaRe antibiotic distribution, microbiological practices, and institutional AMS capacity. Results: Across three survey rounds, 2,574 inpatients were assessed, and antibiotic use remained persistently high (78-80%). Guideline-concordant prescribing improved significantly (p < 0.0001), with modest increases in Access-category and reductions in Reserve-category antibiotics, while Watch-category antibiotics remained (~56%). Microbiological culture requests increased (p < 0.0001), but targeted therapy remained uncommon, with over 95% empirical prescribing. AMS infrastructure improved substantially, including the establishment of committees and the appointment of stewardship leadership. Conclusion: Clinical engagement-based AMS improved institutional capacity and some prescribing indicators but did not reduce overall antibiotic exposure. Ongoing empirical prescribing due to diagnostic limitations and entrenched practices underscores the need for better microbiology and diagnostic support. |
| Contributed Indexing: | Keywords: Antimicrobial resistance; antibiotic prescribing; antimicrobial stewardship; hospital antibiotic use; point prevalence survey |
| Substance Nomenclature: | 0 (Anti-Bacterial Agents) |
| Entry Date(s): | Date Created: 20260710 Date Completed: 20260901 Latest Revision: 20260910 |
| Update Code: | 20260911 |
| DOI: | 10.1080/14787210.2026.2703100 |
| PMID: | 42429481 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1744-8336 |
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| DOI: | 10.1080/14787210.2026.2703100 |