Antibiotic stewardship program (ASP) implementation in humanitarian settings is a
new endeavor. Doctors Without Borders/Médecins Sans Frontières introduced an ASP within
a hospital in Amman, Jordan, where patients from Iraq, Syria, and Yemen with chronic,
often multidrug-resistant, infections related to war are managed. Antibiotics were
reviewed, and real-time recommendations were made to optimize choice, dose, duration,
and route by a small team. Over the first year of implementation, acceptance of the
ASP's recommendations improved. When compared with the year prior to implementation,
antibiotic cost in 2014 declined considerably from approximately $252,077 (average,
$21,006/month) to <$159,948 ($13,329/month), and a reduction in use of broad-spectrum
agents was observed. An ASP in a humanitarian surgical hospital proved acceptable
and effective, reducing antibiotic expenditures and use of broad-spectrum agents.
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Article Info
Publication History
Published online: May 17, 2016
Footnotes
Conflicts of Interest: None to report.
Additional Information: The protocols of the Médecins Sans Frontières (MSF) Amman surgical project were approved within the framework of a formal agreement between MSF, the Jordanian Red Crescent, and the Jordanian Ministry of Health. The present study involved the analysis of data collected for monitoring and evaluation and therefore satisfied the criteria for reports using routinely collected programmatic data, set by the MSF independent Ethics Review Board in Geneva, Switzerland.
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© 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
