2020 Volume 21 Issue 2 Pages 101-105
An antimicrobial stewardship program (ASP) is regarded as an effective countermeasure to Antimicrobial resistance, and it is widely adopted in large hospitals. However, in community-based integrated care systems, small to medium-sized hospitals should work towards implementing an ASP as well. The difficulty for them has been the lack of skilled staff, and the effects are unclear. We started an ASP in our small hospital in April 2018 and validated the effects of our ASP in this study. Our ASP is comprised of 2 parts：① notification of specific antibiotic prescriptions and ② post-prescription audits and weekly reviews. The median (interquartile range) of the number of culture specimens 6 months before 77.5 (70.3〜84.0) and 15 months after 127.0 (117.0〜142.0) starting the ASP increased significantly ( p ＜0.001). The median (interquartile range) of the antimicrobial use density of meropenem in both periods was 31.7 (28.8〜33.7) and 24.1 (19.1〜30.1), respectively. This decrease was not statistically significant ( p ＝0.173). The median (interquartile range) of the detection rate of carbapenem-resistant Pseudomonas aeruginosa in both periods increased from 0.0% (0.0〜0.0%) to 3.6% (1.4〜7.0%), significantly ( p ＝0.007), although it decreased gradually after starting the ASP. In this study, an ASP was effective in a small hospital despite the limited availability of skilled staff.
