EVALUATING A RESTRICTED ANTIBIOTIC PRESCRIBING POLICY: REDUCED UTILIZATION AND EXPENDITURE AT PRINCE ZAID BIN AL-HUSSEIN MILITARY HOSPITAL

Rami Mahmoud Ali AL-Lawama PH*, Ahmad Ibrahim Ahmad Alhasan MD, Osama Esmaeil Albdairat MD, Mai Tawfiq Abdusalam Alrawashdeh PH, Malik Ahed Abdelaziz Al Hyari PH, Mohammad Esmail Albdairat PH

ABSTRACT

Introduction: Excessive antibiotic use stays the main driver for antibiotics resistance (AMR), a global risk to health that keeps putting healthcare systems around the world to the challenge, to address this problem, some systems have implemented antimicrobial stewardship programs (ASPs), to limit the utilize of restricted antibiotics to decrease antibiotics resistance and health care cost. Methodology We will use a retrospective before-and-after design to assess the effects of introducing antimicrobial stewardship measures at Prince Zaid bin Al-Hussein Military Hospital, the pre and post and intervention year(2022)/ (2023) were two consecutive 12-month periods that we will analyze to compare antibiotic prescription habits and related expenditures. To ensure comparability between the two periods, all consumption metrics were adjusted for monthly hospital admission rates, enabling standardized comparisons that account for variations in patient volume. Data Collection Antibiotic utilization data were extracted from the hospital’s pharmacy information system, which documents all dispensed antibiotics along with the quantities supplied (e.g., grams, vials, or units), Monthly hospital admission numbers were obtained from administrative records to calculate standardized consumption indicators such as Defined Daily Dose (DDD) per 100 admissions, where applicable, all datasets were reviewed for completeness and consistency prior to analysis. Results: Colistin: although a 20% rise in bed utilization, there was a 21.4% decrease and 442.5 JD savings. Meropenem -500 mg- 14.4% decrease - savings of 70 JD -, 1 g Ertapenem: 7.3% decrease -168 JD savings-, Imipenem/Cilastatin: 10.4% decrease -364 JD savings-, 19.8% decrease - 886.7 JD savings-, Total Yearly Savings: 1413 JD Reductions were not the result of chance because they were very significant (p < 0.001). Conclusion: Although stronger interventions are required for antibiotics like ertapenem, our study demonstrated significant decreases in the use of high-risk antibiotics (like colistin) and quantifiable saving cost.

Keywords: Antibiotic resistance, cost, restricted protocols, stewardship programs, military hospitals.