Challanges and Implementation of Antimicrobial Stewardship program in diabetic superspeciality tertiary care center in Mumbai | Dhruv Kamlesh Mamtora | S.L. Raheja Hospital |

S.L. Raheja Hospital

Antimicrobial stewardship program implementation is a challenge for private healthcare settings especially it is a multispeciality

hospital catering exclusively to diabetic and oncology patients and in city like Mumbai where antibiotics are sold as over the

counter medicines. Looking at the antimicrobial resistance pattern of institution, we have implemented extensive and elaborated

antimicrobial stewardship program starting from critical care settings and operation theatres with respect to surgical prophylaxis

extending to wards. The challenges faced are multifaced and solution to each and every step needs team work and integration of

multiple specialities. First and foremost was to form SOP as per international guidelines, next step was to prepare antibiograms

and antibiotic policy which was reviewed by clinicians. The team was formed with AMS workgroup and roles were assigned to each

of the key members. Then program was rolled out with CME program highlighting issue of antimicrobial resistance in India and

importance of antimicrobial stewardship progrm and launching program of antibiotic policy. The daily follow up is continuous

and ongoing process. Justification of each restricted antibiotics needs to be implemented by every clinicians prescribing restricted

antibiotic and relevant cultures are sent before empiric antibiotic therapy is started. Compliance is fluctuating but process has >90%

compliance in critical care area where maximum consumption of restricted antibiotics is done. Being a diabetic hospital, no direct

restrictions were done for issuing restricted antibiotics however every issue needs to be justified by issuing consultants supported by

culure evidence. The help from IT department was taken on streamlining process at multiple level and hence the program could be

successful program.

Nosocomial and Healthcare Associated Infections