The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
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Implementing antimicrobial stewardship: lessons and perspectives from a university-affiliated tertiary hospital in Korea

  • Soo Jin Lee (Department of Pharmacy, Seoul St. Mary's Hospital, The Catholic University of Korea) ;
  • Raeseok Lee (Division of Infectious Diseases, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Sung-Yeon Cho (Division of Infectious Diseases, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Dukhee Nho (Division of Infectious Diseases, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Hye Lim Ahn (Department of Pharmacy, Seoul St. Mary's Hospital, The Catholic University of Korea) ;
  • Dong-Gun Lee (Division of Infectious Diseases, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea)
  • Received : 2023.11.17
  • Accepted : 2024.02.03
  • Published : 2024.05.01
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Abstract

Antimicrobial stewardship programs (ASPs) can lower antibiotic use, decrease medical expenses, prevent the emergence of resistant bacteria, and enhance treatment for infectious diseases. This study summarizes the stepwise implementation and effects of ASPs in a single university-affiliated tertiary care hospital in Korea; it also presents future directions and challenges in resource-limited settings. At the study hospital, the core elements of the ASP such as leadership commitment, accountability, and operating system were established in 2000, then strengthened by the formation of the Antimicrobial Stewardship (AMS) Team in 2018. The actions of ASPs entail key components including a computerized restrictive antibiotic prescription system, prospective audit, post-prescription review through quantitative and qualitative intervention, and pharmacy-based interventions to optimize antibiotic usage. The AMS Team regularly tracked antibiotic use, the effects of interventions, and the resistance patterns of pathogens in the hospital. The reporting system was enhanced and standardized by participation in the Korea National Antimicrobial Use Analysis System, and educational efforts are ongoing. Stepwise implementation of the ASP and the efforts of the AMS Team have led to a substantial reduction in the overall consumption of antibiotics, particularly regarding injectables, and optimization of antibiotic use. Our experience highlights the importance of leadership, accountability, institution-specific interventions, and the AMS Team.

Keywords

Acknowledgement

We acknowledge the members of the AMS Committee and the AMS Team for their unwavering dedication to ASPs in the hospital.

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