Farzaneh Dastan - clinical pharmacy department, school of pharmacy, shahid beheshti university of medical sciences, tehran, iran
Hamidreza Jamaati - CRDRC, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Payam Tabarsi - CTERC, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Sahar Yousefian - pharmaceutical care department, NRTLD, tehran, iran
Raha Eskandari - pharmaceutical care department, NRTLD, tehran, iran
Roodabeh Haghgoo - pharmaceutical care department, NRTLD, tehran, iran

Introduction One of the major issues in public health worldwide is antibiotic resistance, and it is associated with imprudent and inappropriate use of antibiotic. Antibiotic resistance can influence on morbidity, mortality, length of stay (LOS), and inappropriate cost. Antibiotic stewardship program(ASP) is one strategy to counter antibiotic resistant organisms. Notably, ASP has positive Impacts on expenditure, utilization and outcome. Reports of ASP in Iranian hospitals are limited. Here, we present key elements that required for successful ASP implementation and evaluate the outcome of the comprehensive ASP. Methods The ASP team compromised 3 infectious disease specialists, 1 clinical pharmacist, and 4 hospital pharmacists. A cohort study of the ASP implementation for 4 broad spectrum antibiotics (meropenem, imipenem, vancomycin, and colistin) was performed in a tertiary referral university affiliated hospital in Tehran, Iran. We collected 200 patients before the ASP implementation and 200 patients byrandomization method after ASP implementation. Clinical outcome, inappropriate antibiotic use, inappropriate cost, and antibiotic resistance were assessed between two periods. Results and Discussion A total 349 patients were assessed, of which 49% were in the interventional period. Baseline characteristics between the two periods were similar except for mean severity score (3.6 ± 2.8 pre vs. 4.2 ± 2.8 post p < 0.032). There was 18% decreased in inappropriate antibiotic use in this short period (P=0.172). LOS was shortened by 3.5 days (P=0.929). Inappropriate cost was declined from 87,586,500T (20853.93$) to 60,827,600T (14482.76$). Indeed, 26,758,900T (6371.17$) was saved in 6 month. Furthermore, antibioticresistance decreased by 33.62%, predominantly XDR in this short period. Conclusion: These results demonstrate shifting toward a rational use of antibiotics, which can lead to clinical and economic benefits

Antibiotic Stewardship Program, Antibiotic Resistance, Inappropriate Antibiotic use, Length of Stay