AMS in inpatient general care

In this video, Dr Mushira Enani talks to Lailah Alawdah about her experience of implementing AMS in the paediatric intensive care unit within King Fahad Medical City, Riyadh.

The video highlights that antibiotic restriction alone often isn’t successful, so they complemented it with a back-end strategy, which involved prospective audit and feedback and antibiotic timeout.

The result was a drop in the use of vancomycin, piperacillin/tazobactam and meropenem.

The main challenge in their hospital was the non-automated health electronic record, which made it hard to gather reliable data monitoring antibiotic use. They also struggled to ensure their strategy was sustainable, as they faced a lack of resources, and struggled with a lack of trust from physicians.

Their main implementation was an antibiotic tracking sheet, which was filled out whenever an antibiotic was prescribed. The following information was recorded:

• Type of drug

• Date of prescription

• Dose given

• Timeout date

Every antibiotic prescribed was reviewed after 72 hours depending on culture results, continuing indication and the plan duration. By assigning an infection prevention control champion and through leadership support, they ensured accountability and over time, the levels of trust rose.