Control of multidrug resistant bacteria in a tertiary care hospital in India

A 300-bed tertiary care private hospital in Gurgaon, Haryana (India)Study Design？ July 2007 to June 2008: Resistance patterns of bacterial isolates were studied.？ July 2008: Phase I intervention programme Implementation of an antibiotic policy in the hospital.？ July 2008 to June 2010: Assessment of the impact of the Phase I intervention programme.？ July 2010 to March 2011: Phase II intervention programme: Formation and effective functioning of the antimicrobial stewardship committee. Statistical correlation of the Defined daily dose (DDD) for prescribed drugs with the antimicrobial resistance of Gram negatives.Phase I intervention programme (July 2008) resulted in a decrease of 4.47% in ESBLs (E.coli and Klebsiella) and a significant decrease of 40.8% in carbapenem-resistant Pseudomonas. Phase II intervention (July 2010) brought a significant reduction (24.7%) in carbapenem-resistant Pseudomonas. However, the resistance in the other Gram negatives (E.coli, Klebsiella, and Acinetobacter) rose and then stabilized. A positive correlation was observed in Pseudomonas and Acinetobacter with carbapenems and cefoperazone-sulbactam.Piperacillin-tazobactam showed a positive correlation with Acinetobacter only. E.coli and Klebsiella showed positive correlation with cefoparazone-sulbactam and piperacillin-tazobactam.An antimicrobial stewardship programme with sustained and multifaceted efforts is essential to promote the judicious use of antibiotics.