Background and Objectives: There is ever growing increase in antimicrobial resistance worldwide mostly due to injudicious and irrational use of antimicrobials in health care institutions and probably due to lack of knowledge among health care professionals about antimicrobial resistance to add to this there is a constant stagnation in development of newer antimicrobials. ICU’s represent the heaviest antibiotic burden within hospital often described as ‘factory creating and amplifying antibiotic resistance. We decided to conduct this before and after study to test the feasibility of a clinical ASP with respect to effect on resistance pattern in pediatric ICU in our hospital with the purpose of finding out the change in resistance pattern with implementation of antimicrobial stewardship programme .

Methods:  This study was a prospective before and after study design which was divided into 3 phases over a span of 12 months. A pre- implementation audit (phase 1) was conducted for 1^st 3 months studying various prescription practices that were being followed in ICU and general observation. Antimicrobial stewardship was implemented in phase 2 for a period of 6 months. After the implementation of ASP in PICU, a similar audit on antimicrobial prescription and usage was done in next three months (phase 3) and theresults compared with the audit of pre-implementation period.

Results: Our study was designed to note effect of antimicrobial stewardship on antimicrobial resistance pattern. Our findings revealed that there was a significant reduction in multidrug resistant (MDR) organisms after implementation of antimicrobial stewardship programme (ASP) (from 58% to 17 % between two phases).

Keywords: antimicrobial stewardship, antimicrobial resistance, multi drug resistant.

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Dr Arnav Shandil

MD Radiodiagnosis Civil Hospital Theog, Shimla H.P (India)