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Article

Assessment of Adherence to the Core Elements of Hospital Antibiotic Stewardship Programs: A Survey of the Tertiary Care Hospitals in Punjab, Pakistan

1
Department of Pharmacy Practice, Lahore Medical & Dental College, University of Health Sciences, Lahore 54600, Pakistan
2
Institute of Information Management, University of the Punjab, Lahore 54000, Pakistan
3
Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan 25200, Malaysia
*
Authors to whom correspondence should be addressed.
Academic Editor: Marc Maresca
Antibiotics 2021, 10(8), 906; https://doi.org/10.3390/antibiotics10080906
Received: 30 May 2021 / Revised: 11 July 2021 / Accepted: 22 July 2021 / Published: 24 July 2021
Background: 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. Aim: To appraise the adherence of the tertiary care hospitals to seven CEHASPs. Design and Setting: A cross-sectional study in the tertiary care hospitals in Punjab, Pakistan. Method: 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: Hospital Leadership Commitment, Accountability, Pharmacy Expertise, Action (Implement Interventions to Improve Antibiotic Use), Tracking Antibiotic Use and Outcomes, Reporting Antibiotic Use and Outcomes, and Education. 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 t-test computed group differences. Result: A total of 68 hospitals (n = 33 public, n = 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: Reporting Antibiotic Use and Outcomes and Tracking Antibiotic Use and Outcomes.Conclusion: 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. View Full-Text
Keywords: antibiotic stewardship; antimicrobial stewardship; hospitals; tertiary care; Pakistan; core elements; CDC; health policy; rational drug use; AMR; LMIC; resistance antibiotic stewardship; antimicrobial stewardship; hospitals; tertiary care; Pakistan; core elements; CDC; health policy; rational drug use; AMR; LMIC; resistance
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MDPI and ACS Style

Mubarak, N.; Khan, A.S.; Zahid, T.; Ijaz, U.e.B.; Aziz, M.M.; Khan, R.; Mahmood, K.; Saif-ur-Rehman, N.; Zin, C.S. Assessment of Adherence to the Core Elements of Hospital Antibiotic Stewardship Programs: A Survey of the Tertiary Care Hospitals in Punjab, Pakistan. Antibiotics 2021, 10, 906. https://doi.org/10.3390/antibiotics10080906

AMA Style

Mubarak N, Khan AS, Zahid T, Ijaz UeB, Aziz MM, Khan R, Mahmood K, Saif-ur-Rehman N, Zin CS. Assessment of Adherence to the Core Elements of Hospital Antibiotic Stewardship Programs: A Survey of the Tertiary Care Hospitals in Punjab, Pakistan. Antibiotics. 2021; 10(8):906. https://doi.org/10.3390/antibiotics10080906

Chicago/Turabian Style

Mubarak, Naeem, Asma S. Khan, Taheer Zahid, Umm e.B. Ijaz, Muhammad M. Aziz, Rabeel Khan, Khalid Mahmood, Nasira Saif-ur-Rehman, and Che S. Zin. 2021. "Assessment of Adherence to the Core Elements of Hospital Antibiotic Stewardship Programs: A Survey of the Tertiary Care Hospitals in Punjab, Pakistan" Antibiotics 10, no. 8: 906. https://doi.org/10.3390/antibiotics10080906

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