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Introducing an antibiotic stewardship program in a humanitarian surgical hospital

      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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      References

        • Tamma P.D.
        • Cosgrove S.E.
        Antimicrobial stewardship.
        Infect Dis Clin North Am. 2011; 25: 245-260
        • Davey P.
        • Brown E.
        • Charani E.
        • Fenelon L.
        • Gould I.M.
        • Holmes A.
        • et al.
        Interventions to improve antibiotic prescribing practices for hospital inpatients.
        Cochrane Database Syst Rev. 2013; (CD003543)
        • Del Arco A.
        • Tortajada B.
        • de la Torre J.
        • Olalla J.
        • Prada J.L.
        • Fernández F.
        • et al.
        The impact of an antimicrobial stewardship programme on the use of antimicrobials and the evolution of drug resistance.
        Eur J Clin Microbiol Infect Dis. 2015; 34: 247-251
        • Boyles T.H.
        • Whitelaw A.
        • Bamford C.
        • Moodley M.
        • Bonorchis K.
        • Morris V.
        • et al.
        Antibiotic stewardship ward rounds and a dedicated prescription chart reduce antibiotic consumption and pharmacy costs without affecting inpatient mortality or re-admission rates.
        PLoS ONE. 2013; 8 (e79747)
        • Fakri R.M.
        • Al Ani A.M.
        • Rose A.M.
        • Alras M.S.
        • Daumas L.
        • Baron E.
        • et al.
        Reconstruction of nonunion tibial fractures in war-wounded Iraqi civilians, 2006-2008: better late than never.
        J Orthop Trauma. 2012; 26: e76-82
        • Murphy R.A.
        • Ronat J.B.
        • Fakhri R.M.
        • Herard P.
        • Blackwell N.
        • Abgrall S.
        • et al.
        Multidrug-resistant chronic osteomyelitis complicating war injury in Iraqi civilians.
        J Trauma. 2011; 71: 252-254
        • Teicher C.L.
        • Ronat J.B.
        • Fakhri R.M.
        • Basel M.
        • Labar A.S.
        • Herard P.
        • et al.
        Antimicrobial drug-resistant bacteria isolated from Syrian war-injured patients, August 2011-March 2013.
        Emerg Infect Dis. 2014; 20: 1949-1951
        • Pollack L.A.
        • Srinivasan A.
        Core elements of hospital antibiotic stewardship programs from the Centers for Disease Control and Prevention.
        Clin Infect Dis. 2014; 59: S97-100