A retrospective review of a 2-year strong antimicrobial stewardship program in a tertiary care institute in Mumbai

BACKGROUND INFORMATION: Many institutes have implemented a strict antimicrobial stewardship (AMS) program in the postantibiotic era. AIM: To investigate how the resistance pattern changes after implementation of a stringent AMS programme. METHODOLOGY: It employs a defined daily dose methodology (DDD). The formulae listed below are used to compute this for two periods: October 2015 to October 2017 (Period 1) and October 2017 to October 2019 (Period 2) (Period 2).DDD = Antibiotics used in total (g) per yearDDD = Total antibiotics usage(g)in a year/ DDD (from WHO) The length of stay was determined using the data from the hospital's information system (HIS). The patterns of resistance to the limited antibiotics are vancomycin, linezolid, tigecycline, and colistin. In both Periods 1 and 2, skin and soft-tissue infections, urinary tract infections, bloodstream infections, and respiratory tract infections were studied in both periods. RESULTS: In the year from October 2015 to October 2017, 4569 patients received limited antibiotics out of a total of 14,544 admissions. The average length of stay was 7.48 days in Period 1, however, it was reduced to 3.96 days in Period 2 out of 15,199 patients. In vitro isolate sensitivities to vancomycin, linezolid, tigecycline, and colistin were increased. CONCLUSION: Some of the most common antibiotics were used less frequently. This appears to be linked to a shorter stay in the hospital and increased antibiotic susceptibility.