Conformity of administration of Imipenem and Meropenem with the antimicrobial stewardship program in a referral teaching hospital in Iran

Background and aim: Given the major importance of antimicrobial resistance, the implementation of the Antibiotic Stewardship Program (ASP) in medical settings is critical. The current research aimed to compare the administration of imipenem and meropenem with the ASP guidelines in a referral teaching hospital in Iran.Materials and method: The medical records of patients, who received either meropenem or imipenem at xx Hospital in Semnan, Iran, from ۲۱ March ۲۰۱۷ until ۲۰ March ۲۰۱۹, were evaluated by the ASP, according to the instructions from Iran's Health Ministry. The obtained data were reported based on a checklist consisting of six items. If the action taken for the patient conformed to the item specified in the ASP, it would obtain a score of one; otherwise, a score of zero. The sum of scores (range: ۰–۶) was analyzed and reported. Data were analyzed in SPSS version ۲۳, using ANOVA, Chi-square, and independent t-test. P values <۰.۰۵ were used to demonstrate significant differences.Results: The mean duration of imipenem or meropenem administration was ۹.۲±۸.۰ days. ۶۰۳۲ vials (۱gr/vial) of imipenem or meropenem were prescribed, ۲۱۰ patients had meropenem and ۸۷ imipenem, which the cost was ۱۰۰۰۰۰ US$. In ۶۴.۲% of patients, there was no indication according to antibiotic stewardship guidelines. The mean score obtained based on antibiotic stewardship guidelines was ۱.۵۵±۱.۲. Obtained score at ۵۳ records (۱۷.۸%) was three and in ۱۸ (۶.۱%) was four. The mean score for antibiotic stewardship in intensive care units was higher and in the surgical ward was lower than in other wards (P=۰.۰۰۲).Conclusion: Antibiotic prescribing in our center was inappropriate in terms of indication, type, and dose of medication in compliance with the instructions from Iran's Health Ministry, especially in surgical wards. It seems necessary to take effective steps for planning rational antibiotic prescribing.

کلیدواژه ها:

Antibiotic Stewardship Program ، Antimicrobial Resistance ، Imipenem ، Meropenem