A Comparative Study of Meropenem Utilization and Clinical Outcomes in Two Hospitals in Saudi Arabia Employing Different Antimicrobial Stewardship Strategies

Abstract Background: Effective antimicrobial stewardship (AMS) programs are crucial for managing infectious diseases and reducing antimicrobial resistance. Recent efforts in Saudi Arabia have demonstrated progress in reducing broad-spectrum antibiotic use through these programs. This study aims to compare two antimicrobial stewardship strategies implemented in Saudi hospitals to evaluate their impact on meropenem use and patient clinical outcomes. Materials and Methods: A retrospective study analyzed data of patients hospitalized from 2020 to 2023 at two Saudi hospitals: King Fahad Specialist Hospital (Hospital A) with 9012 admissions and King Abdulaziz University Hospital (Hospital B) with 56,765 admissions. Endpoints included meropenem use (defined daily dose and days of therapy [DOT] per 100-patient days), mortality rates, and length of stay. Statistical analyses, including chi-square, Fisher’s exact, Mann–Whitney U tests, and regression, were conducted using SPSS version 24 (IBM Corp., Armonk, NY, USA). Results: The study involved 226 patients: 134 from Hospital A and 92 from Hospital B. Hospital B had older patients and more cases of urinary tract infections, while Hospital A had more cases of polymicrobial cultures and higher meropenem use. Hospital A implemented higher meropenem doses and longer duration of therapy. Mortality rates were similar, but Hospital A had a longer length of stay (19 days vs. 12 days). Conclusion: The study showed substantial variations in meropenem use between two hospitals, highlighting the importance of focus on antibiotic stewardship. Further research should be conducted to investigate these variances and their impact on patient clinical outcomes.