Evaluation of carbapenem antimicrobial stewardship program at a tertiary care hospital: A prospective interventional study

This study aimed to determine physicians' acceptance rate of the Antimicrobial Stewardship Program ASP interventions in critically ill patients and to compare the clinical outcomes between accepted and rejected ASP groups. The study included patients on carbapenem therapy who were advised ASP interventions between 18-75 years of age and admitted in ICU/HDU from December 2020 to May 2021 at Liaquat National Hospital Karachi. Based on acceptance by the primary physician, data is divided into two groups. Outcomes were observed based on clinical improvement within seven days, 30-day mortality and readmission rates. Among 134 non-adherent prescriptions, Carbapenem ASP interventions were accepted in 117 (87.3%) patients. The accepted interventions improved clinical outcomes for most patients within seven days, 99 (84.6%). An insignificant association in death between the accepted versus rejected group within 30 days (p=1.000) was observed. On the other hand, a significant association in readmission was seen between both groups within 30 days (p=0.036). This study concluded that carbapenem prescriptions guided by the 'Antimicrobial stewardship program' are widely accepted in Pakistan and have improved clinical outcomes within 30 days of intervention.