ANTIBIOTIC RESTRICTION POLICIES: A COMPARATIVE STUDY OF IMPLEMENTATION AND OUTCOMES AT PRINCE ZAID BIN AL-HUSSEIN MILITARY HOSPITAL AND PRINCE ALI BIN AL-HUSSEIN MILITARY HOSPITAL

Dr. Amjad A. G. Alhawamdeh*, Dr. Ma’moon K. H. A. AL-Khawaldeh, Dr. Rashid A. S. Alharahsheh, Dr. Ma’moon M. A. El- Harahshah, Dr. Hossam E. S. Alsmairan, Mohammad E. M. Albdairat Pharm-D, Rami Mahmoud Ali AL-Lawama P. H.

ABSTRACT

Introduction: A major threat to global health, antimicrobial resistance (AMR) raises hospital stays, costs, and
mortality rates, Applying restrictive antimicrobials policies in hospitals, where certain high-risk antibiotics need
special authorization before usage, stays an important strategy to fight AMR. Although many Jordanian hospitals
have implemented such rules, the majority of research to far has concentrated on individual hospitals rather than
comparing practices across hospitals, these results in a lack of knowledge regarding the actual implementation of
policies and their efficacy in various contexts. In order to close that gap, this study compares the antibiotic
restriction policies of Prince Zaid bin Al-Hussein military Hospital and Prince Ali bin Al-Hussein military
Hospital, two of Jordan's large military hospitals. Methodology: The essential method involves a comparative
analysis of restricted antibiotic use between the two military hospitals, Data on the total consumption of targeted
antibiotics and the corresponding total patient-days (calculated from admissions and bed occupancy) will be
collected then This will allow for the calculation and comparison of a standardized consumption rate (using the
metric DDD/100 patient-days) for each institution, In parallel, the total acquisition cost for these drugs will be
compiled and compared, The analysis will then integrate these findings, examining the relationship between
consumption rate and financial cost to provide a clear, brief evaluation of both usage patterns and economic
outcomes. Results: Imipenem/Cilastatin (1 g) was the most dispensed restricted antibiotic in both hospitals, Ali
Hospital had higher annual bed occupancy 49,802 bed-days compared to Zaid Hospital 14,601 bed-days, After
standardizing consumption, the rates of antibiotic use per 100 bed-days were similar between the two hospitals.
The financial analysis revealed the cost per DDD is identical for each antibiotic in both hospitals, but
Imipenem/Cilastatin representing the highest cost driver, Zaid Hospital established higher costs per 100 bed-days
for all antibiotics. Conclusion: Although Ali Hospital dispensed a higher number of restricted antibiotic vials, the
adjusted consumption rates and associated costs per 100 bed-days were very similar between Ali and Zaid
hospitals. Imipenem/cilastatin was the most frequently used restricted antibiotic and the major contributor to
financial burden in both institutions; these findings indicate comparable prescribing patterns.

Keywords: Antibiotics, restricted antibiotics, antimicrobials, cost.