Antimicrobial Stewardship and Resistance Patterns in Ganjavian Hospital, Dezful, Southwest of Iran: A Two-Year Analysis

Background: Antimicrobial stewardship studies are essential to prevent microbial resistance, ensure proper antimicrobial use, and reduce treatment costs. This study aimed to examine the prescription trends of eight costly antimicrobial agents, including carbapenem (imipenem/meropenem), voriconazole, vancomycin, liposomal amphotericin B, colistin, linezolid, teicoplanin, and caspofungin, at Ganjavian hospital in Dezful. Methods: This cross-sectional study collected prescription forms for the eight targeted antimicrobials from March ۲۰۱۸ to March ۲۰۲۰. The recorded data included patient information, microbiological findings, infection sites, and details of antimicrobial use. Results: The analysis of ۲۰۰ patients revealed that the most common infection sites were the bloodstream (۴۱%), respiratory system (۲۴.۵%), and unidentified sources (۱۳%). The majority of patients were admitted to internal wards (۲۹.۵%), general intensive care units (۲۵.۵%), and neonatal intensive care units (۱۳%). The predominant bacterial isolates were Escherichia coli (۱۹.۵%), Acinetobacter baumannii (۱۴.۵%), Pseudomonas aeruginosa (۱۲.۵%), and Staphylococcus aureus (۱۱.۵%). Multidrug-resistant (MDR) bacteria caused ۵۳% of infections, and ۳۳.۵% were caused by bacteria resistant to all tested antimicrobials. Conclusion: MDR bacteria pose a significant challenge, underscoring the critical need for nosocomial infection control, antimicrobial stewardship, and continuous monitoring of antimicrobial resistance patterns in this medical center.