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Background: Antimicrobial stewardship programs refer to antibiotic policies, antibiotic management programs, and antibiotic control programs. According to the Centers for Disease Control and Prevention (CDC) Project ICARE, all hospitals reported having an antibiotic formulary, and 91% used at least one other antimicrobial control strategy. Materials and Methods: The present study is a retrospective and observational study. All information was noted and surveyed sporadically. Any deviations from the agreed criteria were communicated, discussed, and documented. Antibiotic stewardship started from an inpatient setting. In the first phase, the patient pool from inpatient was addressed. For the prospective audit, two components had been recognized to have an evidence level 1. These were multidisciplinary rounds of infectious diseases patients and the use of antimicrobials. Result: In Medicine ward, the most common class of drugs was beta-lactam; in betalactam, a combination of piperacillin/tazobactam, amoxicillin/clavulanic acid, and macrolides was used with a mean dose of 1408.18 g. While in orthopedics, most common drugs for prophylaxis use were found to be cephalosporins (cefazolin first generation) with a mean dose of 937.07 ± 741.81 g to reduce surgical site infections. Prophylactic use of beta-lactam (amoxicillin/clavulanic acid) was prescribed for the most of the cases of Ears, Nose and Throat (ENT) surgery with mean dose of 1019.63 g as well as in pediatrics with mean dose of 579.47 g. Conclusions: Antimicrobial stewardships have a significant impact on the reduction of targeted and empiric antibiotic use, healthcare costs, and antimicrobial resistance in inpatient settings. [ABSTRACT FROM AUTHOR]

Background: As future practitioners, undergraduate medical students have a key role in the antimicrobial stewardship program (ASP). However, at present, there are not much data about their knowledge and perception of antibiotic resistance and ASP. Methods: This was a cross-sectional questionnaire-based survey administered to the prefinal- and final-year undergraduate medical students of a tertiary care institution. Results: One hundred and ninety-seven students participated in our study constituting 70% response rate. The mean difference in knowledge score between prefinal- and final-year students was 0.77 (95% confidence interval: 0.30–1.24, P = 0.0016). Thirty-seven (39.7%) prefinal- and 57 (54.8%) final-year students knew the correct definition of antimicrobial stewardship. Majority of the participants, i.e., 66 (70.9%) prefinal-year and 80 (76.9%) final-year students perceived antibiotic resistance as a public health problem. Principal component analysis revealed the greater role of attitude-related questions. Conclusion: Good knowledge and positive attitude are paramount for the effective implementation of the antibiotic stewardship program. Our study revealed that the knowledge gap exists among the undergraduate students about the rational use of the antibiotic stewardship program. It was also revealed that the role of attitude plays a more significant role than knowledge for the proper understanding of the program. A sustained effort is required to make them aware of the rational use of antibiotics by incorporating the knowledge and practice of the ASP into their study curriculum. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The objective of the study was to explore the prescribing practices, knowledge, and attitudes of primary care doctors and community pharmacists, regarding antibiotic use in acute upper respiratory tract infections (URTI) and diarrhea in children to better understand causes of misuse and identify provider suggestions to change such behavior. MATERIALS AND METHODS: Two focus group discussions (FGDs) each were conducted with primary care government doctors (GDs), private general practitioners (GPs), pediatricians, and community pharmacists in Delhi. Each FGD had 8-12 participants and lasted 2 h. Furthermore, 22 individual face-to-face semi-structured interviews were conducted with providers of varying type and experience at their workplaces. Thematic and summative qualitative content analysis was done. RESULTS: All groups admitted to overusing antibiotics, GPs appearing to use more antibiotics than GDs and pediatricians for URTI and diarrhea in children. Pharmacists copy the prescribing of neighborhood doctors. Antimicrobial resistance (AMR) knowledge was poor for all stakeholders except pediatricians. Causes for prescribing antibiotics were patient pressure, profit motive, lack of follow-up and in addition for GDs, workload, no diagnostic facility, and pressure to use near-expiry medicines. Knowledge was gained through self-experience, copying others, information from pharmaceutical companies, and for some, training, continuous medical education/conferences. All groups blamed other professional groups/quacks for antibiotic overuse. Interventions suggested were sensitizing and empowering prescribers through training of providers and the public about the appropriate antibiotic use and AMR and implementing stricter regulations. CONCLUSIONS: A package of interventions targeting providers and consumers is urgently needed for awareness and change in behavior to reduce inappropriate community antibiotic use. [ABSTRACT FROM AUTHOR]