Impact of antibiotic stewardship program in surgical icu’s at tertiary care hospital in south india: an ambispective observational study

Background: The surgical ICU’s are the core areas in the hospital where antibiotics are frequently prescribed to treat number of infections. The consequence of irrational antibiotic use can result in drug resistance and associated rise in treatment expenditure. Aim: To study the impact of antibiotic stewardship program on antibiotic use in surgical ICU’s and surgical wards at tertiary care hospital in south India. Methodology: All the patients in surgical ICU’s and surgical wards who were prescribed with WHO watch and reserve antibiotics were included in the study regardless of sex. The data were collected retrospectively from October 2021 to January 2022 (pre-ASP) and prospectively, starting from February 2022 to May 2022 (Post-ASP). The consumption of watch and reserve antibiotics were compared in two time periods and drug use density is expressed as by anatomical therapeutic chemical (ATC)/defined daily doses (DDD) and normalized per 100 bed days. Results: From a total of 363 prescriptions, 274 appropriate prescriptions and 89 inappropriate prescriptions were observed. The result shows an increase in appropriate use and also gradual decrease in inappropriate use of targeted antibiotics. An overall -18.46% decrease in antibiotic consumption was observed between the pre-ASP and post-ASP phases measured in DDD/100 bed days for target antibiotics. The consumption of the targeted antibiotics reduced at the end of study. The consumption of vancomycin increased and the consumption of cefixime was reduced significantly (P-value = 0.015). Conclusion: As a conclusion, antibiotic stewardship program in hospital surgical ICU’s are effective in reducing the antibiotic consumption.