Impact of an antimicrobial stewardship program on colistin resistance in a tertiary care hospital in Pakistan: a quasi-experimental study
Year: 2025
Type: article
Abstract: Background: Colistin is a last-resort antibiotic used against infections caused by multidrug-resistant gram-negative organisms, particularly carbapenem-resistant strains. Rising resistance to colistin is a significant global concern. To address this, an Antimicrobial Stewardship (AMS) Program was introduced in our hospital, including pre-authorization protocols for colistin use. Objective: To evaluate the prevalence of colistin-resistant organisms and determine the impact of AMS implementation on their occurrence and associated clinical outcomes. Methods: , Pseudomonas aeruginosa, or Acinetobacter spp. were included. Clinical and microbiological data were analyzed to assess differences in organism prevalence, mortality, and hospital stay duration. Results: was the most frequently isolated organism in both groups. The overall in-hospital mortality rate was 34%, and the average length of stay was approximately 20 days, with no significant differences between periods. Despite AMS implementation, colistin resistance prevalence did not decline. Conclusion: While the AMS facilitated better identification and documentation of colistin-resistant infections, it did not significantly reduce their prevalence or associated mortality. Strengthened stewardship measures, continuous compliance monitoring, and alternative therapeutic strategies are needed to curb rising colistin resistance in high-burden settings.
Source: PubMed
DOI: 10.3205/id000097
Authors: Irshad, Memoona, Sethi, Sher Muhammad, Jamil, Bushra, Irfan, Seema, Awan, Safia, Raza, Shamim, Zafar, Aafia
Language: English
Subfield: Applied Microbiology and Biotechnology
Field: Immunology and Microbiology
Domain: Life Sciences
Open Access status: green
OpenAlex ID: W7106233248
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