Evaluation of an Hospital-Based Post-Prescription Review and Feedback Pilot in Kathmandu, Nepal.
Joshi RD, Zervos M, Kaljee LM, Shrestha B, Maki G, Prentiss T, Bajracharya D, Karki K, Joshi N, and Rai SM. Evaluation of an Hospital-Based Post-Prescription Review and Feedback Pilot in Kathmandu, Nepal. Am J Trop Med Hyg 2019.
The American journal of tropical medicine and hygiene
Capacity building is needed in low- and middle-income countries (LMICs) to combat antimicrobial resistance (AMR). Stewardship programs such as post-prescription review and feedback (PPRF) are important components in addressing AMR. Little data are available regarding effectiveness of PPRF programs in LMIC settings. An adapted PPRF program was implemented in the medicine, surgery, and obstetrics/gynecology wards in a 125-bed hospital in Kathmandu. Seven "physician champions" were trained. Baseline and post-intervention patient chart data were analyzed for changes in days of therapy (DOT) and mean number of course days for IV and oral antibiotics, and for specific study antibiotics. Charts were independently reviewed to determine justification for prescribed antibiotics. Physician champions documented recommendations. Days of therapy per 1,000 patient-days for courses of aminoglycoside (
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