Towards Reducing the Heavy Usage of Controlled Antibiotics in Seberang Jaya Hospital

  • Ann Lisa Arulappen Pharmacy Department, Seberang Jaya Hospital, Penang State Health Department, Ministry of Health Malaysia
  • Gaiyathri Shanmugam Pharmacy Department, Seberang Jaya Hospital, Penang State Health Department, Ministry of Health Malaysia
  • Mei Chen Lim Pharmacy Department, Seberang Jaya Hospital, Penang State Health Department, Ministry of Health Malaysia
  • Elsie Yuen Ling Teoh Pharmacy Department, Seberang Jaya Hospital, Penang State Health Department, Ministry of Health Malaysia
  • Mohd Ashraf Nor Muhammad Pharmacy Department, Seberang Jaya Hospital, Penang State Health Department, Ministry of Health Malaysia
  • Choo Hau Lim Infection Control Unit, Seberang Jaya Hospital, Penang State Health Department, Ministry of Health Malaysia
  • Joo Thye Cheng Medical Department, Seberang Jaya Hospital, Penang State Health Department, Ministry of Health Malaysia
  • Siti Hawa Hamzah Microbiology Unit, Seberang Jaya Hospital, Penang State Health Department, Ministry of Health Malaysia
  • Yen Yen Woo Microbiology Unit, Seberang Jaya Hospital, Penang State Health Department, Ministry of Health Malaysia
  • Adawiyah Bakar Aneasthesiology Department, Seberang Jaya Hospital, Penang State Health Department, Ministry of Health Malaysia

Abstract

Seberang Jaya Hospital (HSJ) has been listed as Penang’s highest controlled antibiotic user since 2018. It has led to the prevalence of resistant microorganisms and increased antibiotic expenditures. Therefore, reducing the usage of controlled antibiotics was an attempt done to reduce the defined daily dose (DDD)/1000 patient-days (PD) and improvise on the antibiogram and cost. The study aimed to reduce the DDD/1000 PD by over 30% from the baseline upper limit (UL) in 2019 for HSJ. A quality improvement study involving four cycles was conducted
from July 2019 to June 2022. The sampling was done utilising a controlled antibiotic order form, an antimicrobial stewardship database and knowledge assessment questionnaires. During the verification study, the DDD/1000 PD was above the UL (4.5%), which was 25.5% below the standard. The contributing factors were the incomplete review of antibiotics after 72 hours (84%), inappropriate selection of antibiotics during the initial therapy (61%) and after review (88%), pending relevant culture results (36%) and unclear Standard Operating Procedure (SOP) in supplying the antibiotics (49%). Strategies developed were continuous education for healthcare professionals, formulation of new antibiotic guidelines and formulary restrictions, and development of an electronic antibiotic application. The Achievable Benefit Not Achieved (ABNA) was reduced from 25.5% to -6.7%. Improvement in the Model of Good Care (MOGC) was shown to affect the appropriate selection of antibiotics during the initial therapy from 39% to 99% and after review from 12% to 87%; active tracing of relevant results from 64% to 100%; active review of antibiotics from 16% to 100%; and proper supply of antibiotics based on the SOP from 51% to 90%. Approximately RM 165,000.00 (USD 36,600.00) of cost savings were accomplished. Improvement was seen in the antibiogram. Several strategies were implemented at the other hospitals, such as the electronic antibiotic application.

Published
2023-11-20
How to Cite
ARULAPPEN, Ann Lisa et al. Towards Reducing the Heavy Usage of Controlled Antibiotics in Seberang Jaya Hospital. Q Bulletin, [S.l.], v. 1, n. 32, p. 58-70, nov. 2023. ISSN 2716-6554. Available at: <https://myjms.mohe.gov.my/index.php/qbulletin/article/view/22021>. Date accessed: 21 july 2024.
Section
Articles

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