[ Pharmaceutical Sciences Asia - ONLINE ]
E-ISSN 2586-8470
[ Journal Abbreviation: Pharm.Sci.Asia ]
Mahidol University Journal of Pharmaceutical Sciences
  FORMER NAME   "Mahidol University Journal of Pharmaceutical Sciences" Published Since 1974


DOI: 10.29090/psa.2023.04.23.664Pharm Sci Asia 2023; 50(4), 289-295

The impact of antimicrobial stewardship on appropriate use of antimicrobial agents for nosocomial infections caused by gram-negative bacilli in a university hospital in Thailand

Sang Usayaporn1, Terapong Tantawichien2, Preecha Montakantikul3*

1 Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand
2 Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
3 Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand

Antimicrobial stewardship programs (ASP) are crucial for promoting appropriate antimicrobial use and combatting resistance. This prospective cohort study evaluated the impact of ASP on the appropriate use of antimicrobial agents in a university hospital. This study was conducted over a 6-month period, comparing the outcomes of patients managed under the ASP with those in a control group. The primary objective was to assess the appropriate use of antimicrobials. Secondary outcomes included de-escalation rate, duration of therapy, and clinical outcomes (infection-related mortality, clinical and microbiological cure). A total of 311 patients were enrolled in the study, with 181 in the ASP ward and 130 in the control ward. Baseline characteristics were generally comparable between the two groups, except for a lower median age in the ASP group. The appropriateness of antimicrobial use did not significantly differ between the ASP and control groups (67.96% vs. 68.46%, P=0.925). However, the ASP group showed a higher rate of de-escalation (43.09% vs. 23.85%, P<0.01) and a shorter duration of antimicrobial therapy (8 vs. 10 days, P=0.031). Importantly, clinical cure rate was higher in the ASP ward (83.43% vs. 67.69%, P=0.01). There were no significant differences in infection-related mortality and microbiological cure between the two groups. The ASP implementation in a university hospital resulted in increased rates of de-escalation and shorter durations of antimicrobial therapy while the overall appropriate use did not significantly improve. These findings highlight the potential benefits of ASP in optimizing antimicrobial treatment without compromising clinical outcomes.


Antimicrobial stewardship programs, Appropriateness of antimicrobial use, De-escalation, Duration of therapy, Clinical outcomes

Download full paper (PDF File size: 488.82 KB.)

October-December 2023

See other volume


July-September 2023

See other volume


April-June 2023

See other volume


January-March 2023

See other volume


Aims and Scope
Editorial Board
Publication Ethics
Instruction to Authors
All Volumes & Issues
Submit Online
Contact us
Faculty of Pharmacy Mahidol University
Mahidol University

Pharmaceutical Sciences Asia by Faculty of Pharmacy, Mahidol University, Thailand is licensed under CC BY-NC-ND 4.0

    Copyright © 2017-2024
    Faculty of Pharmacy, Mahidol University, THAILAND

We use Cookies

This site uses cookies to personalise your experience and analyse site traffic. By Clicking ACCEPT or continuing to browse the site you are agreeing to our use of cookies.