Unmasking the Knowledge Practice Gap in Antibiotic usage in a Tertiary Care Hospital – A Quality improvement initiative

BACKGROUND: Antibiotic use surveillance in hospitals is important for monitoring and controlling the use of antibiotics, which can help prevent the development and spread of antimicrobial resistance (AMR).(1) Hospital antimicrobial use can be quantified accurately using patient-level surveillance.(2) Collection of data concerning the timing, dose, restricted antibiotic use can help in antimicrobial stewardship and unmask a knowledge-practice gap. We are presenting the surveillance data from our tertiary care hospital so as to unmask the challenges and to bridge the knowledge practice gap. METHODS: Retrospective data at the end of each month collected by the infection control nurses was analyzed for compliance and missed practices. The parameters noted are appropriate prophylactic antibiotic before surgery, timing of antibiotics, empirical treatment, culture sensitivity report directed compliance and restricted antibiotic usage in Surgical ICUs. The data was then analyzed in the form of proportions and percentages. RESULTS: There was 100% compliance with respect to appropriateness of prophylactic antibiotic before surgery and timing of antibiotics. Compliance to empirical treatment based on HICC policy varied between 9%-30%. Culture and sensitivity report directed compliance was 30–70%. Restricted antibiotic usage in Surgical ICUs is as shown in table below. CONCLUSIONS: Hospital antimicrobial use can be quantified accurately using patient-level surveillance. Collection of data concerning the timing, dose, restricted antibiotic use can help in antimicrobial stewardship.