Evaluation of Antimicrobial Stewardship Programs and antibiotic prescribing patterns among physicians in ambulatory care settings in Jordan

ABSTRACT

Objectives

Currently, there is an urgent need to implement an Antimicrobial Stewardship Program (ASP) in outpatient settings since nearly half of the antibiotic prescribing is inappropriate or unnecessary. The implementation of ASP should emphasize educational interventions that are more interactive. This study examines the adoption of outpatient ASP by physicians in Jordan.

Methods

A cross-sectional study was conducted between 2 March 2022 and 20 May 2022 at major hospitals in Jordan. The survey was distributed randomly among (n = 187) Jordanian physicians.

Results

It was found that more than half of the physicians were females (51.9%). The participants who reported not including antibiotic stewardship-related duties in position descriptions were (40.1%). While (46.5%) of participants reported writing and displaying public commitments supporting antibiotic stewardship in ambulatory care settings. Physicians’ adoption of (action) core elements of ASPs in ambulatory care settings was positive. Almost (24.6%) reported a lack of self-evaluation of their antibiotic-prescribing practices. It was reported that (69.5%) of physicians used effective communication strategies to educate patients about when antibiotics are necessary.

Conclusion

It was fair adoption of the core elements in the ambulatory care settings among Jordanian physicians. Progress necessitates a comprehensive strategy tailored to the needs of the health system.

KEYWORDS:

• Antimicrobial stewardship
• Jordan
• core elements
• adoption
• outpatient settings

Article highlights

• With the high rates of improper antibiotic prescription among Jordanian physicians, there is a critical need to implement ASP in outpatient settings.

• Antimicrobial stewardship refers to strategies used at hospital and community levels to address antibiotic resistance and misuse.

• The private sector exhibits a lack of adherence among physicians in Jordan with regard to the implementation of the ASP outpatient core elements.

• The absence of antibiotic stewardship-related responsibilities in job descriptions was reported by around 40.1% of the participants.

• For ASP adoption, it is emphasized to have an interactive educational intervention.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Author contributions

M Ababneh: Conceived and designed the study, conducted literature review, and wrote the manuscript. H Abujuma: Collected and organized data, and contributed to manuscript preparation. S Altawalbh: performed data analysis, contributed to data interpretation and manuscript writing. S Aldemour: Contributed to study design, data collection, data interpretation, and critically revised the manuscript for intellectual content. All authors have read and approved the final manuscript.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.