Effect of Antimicrobial Stewardship Programme (ASP) Development in Nakornping Hospital

Abstract

The strategy to drive the antimicrobial resistance management in Thailand is follow the “Global Action Plan on Antimicrobial Resistance. In Thailand: 2016-2021”. It was found that the antimicrobial consult forms were returned for expert consultant only 19.56 % in Nakornping Hospital. Therefore, the development of management by pharmacists has been performed for increasing the returning of consult form.

Objective: To study the effect of the developed ASP system on the returned rate of antimicrobial consult forms (ABO) and antimicrobial consumption.  

Study design: Retrospective analytical study was used to collect the antimicrobial consult forms and the data from electronic data base of Nakornping Hospital. Only patients who admitted between 1 Octoble 2013 – 31 December 2019 were enrolled in this study. The antimicrobial cost, defined daily dose (DDD) and the effect of developed system, especially correlation between carbapenem and non-carbapenem by using multilevel mixed model.

Result of the study:  The submission rate of ABO was increase from 19.65 % in 2017 to 44.93 % in 2018 and 46.32 % in 2019. The targeted drug cost was decreased between 2016- 2019 as 19.7, 17.5, 16.4 and 15.7 million baht, respectively. Comparing the usage of carbapenem with non-carbapenem, the effect on DDD of each drug was significantly reduced by 0.277 [95% CI, (-0.46) –

(-0.10),p= 0.002] in the period of 42 months.  In bugget year (2019), analysed ABO form for 1,815 times. Docters agreed with the suggestion of expert 1,646 times (90.69%).

Conclusion: The system development of using ASP by pharmacist in Nakornping Hospital was increased the returning of the antimicrobial consult form, decreased the total of antimicrobial cost used and changed DDD of target drugs consumption, significantly.