A Systematic Review of Antimicrobial Stewardship Programs Implementation in Middle Eastern Countries

Int J Infect Dis. 2021 Mar 15:S1201-9712(21)00253-8. doi: 10.1016/j.ijid.2021.03.035. Online ahead of print.


BACKGROUND: Antimicrobial resistance is a serious threat to global health. Antimicrobial Stewardship Programs (ASPs) are adopted by healthcare systems worldwide. This review aims to evaluate the published practices of ASPs in Middle East countries.

METHODS: We searched in PubMed/ MEDLINE, EMBASE, EBSCO, Cochrane library, Google, and Google Scholar electronic databases for studies published from January 2005 to December 2020, assessing ASP practices in Middle Eastern countries following PRISMA guidelines.

RESULTS: Out of the 422 titles identified, 20 studies met the inclusion criteria. Eight studies were conducted in the Kingdom of Saudi Arabia. Five studies were conducted in Qatar, and two studies were conducted in Lebanon and Jordan, one study in Palestine and UAE, and one multinational study. Different ASP practices, including prospective auditing and feedback, pre-authorization, tracking, antibiotic restriction, education, de-escalation, and intravenous to-oral switch, were reported. ASP practices correlated with improved susceptibility rate and decrease in antimicrobial use.

CONCLUSION: Outcomes of this review reveal the scarcity of ASP practices data. The impact of introducing ASPs in hospitals in Middle Eastern countries demonstrate favorable clinical effects. Policymakers and stakeholders should promote and invest in implementing these programs as an essential component of the healthcare systems.

PMID:33737132 | DOI:10.1016/j.ijid.2021.03.035