1. ANTIMICROBIAL STEWARDSHIP PROGRAME

2. WHAT IS THE PROBLEM ? Attractiveness of new antibiotics to physicians
Exaggerated claims by pharmaceutical industry
After introduction of AB to medicine in 1940’s
Cuurent situation in USA,60% OF HOSPITALIZED patients receive atleast one dose of AB (50% unnecessery)

3. UNWANTED CONSEQUENCE OF ANTIMICROBIAL THERAPY
Adverse reaction
Increased length of stay
Increased cost of hospitalization
30%-50% of drug budget
Predisposition to secondary infections
Emergence of drug resistance microorganism
Unique aspect which affects on other patients

4. FACTORS LEAD TO INAPPROPRIATE USE OF ANTIBIOTICS
Good intention
Inappropriate dosing
Inappropriate prophylaxis
Pressure from the patients
Time constraints
Independency to paraclinic results
Inadequate knowledge about infectious disease
Malpractice considerations
“spiraling empiricism”
Heavy promotion by drug companies

5. WHAT SHOULD WE DO ? Educational programs Microbial antibiogram updates
Treatment updates
Prophylaxis updates
Interventional programs
Treatment protocols
Medical
surgical
Prophylaxis protocols
Surgical
Antimicrobial formulary restrictions