Antimicrobial Stewardship in Bacterial Meningitis: A Case-Control Study

Abstract Background: Inappropriate use of antimicrobials leading to the exponential increase in antimicrobial resistance has been a matter of global concern for the last several years. The antimicrobial stewardship program (ASP) aims to optimize the antimicrobial prescribing via multidisciplinary institutional approach to improve patient’s prognosis, reduce the chances of antimicrobial resistance, and reduce hospital’s financial burden. Objective: The aim of this study is to apply the principles of antimicrobial stewardship and then analyze the response of two groups of meningitic patients to the empirical treatment and CSF culture & sensitivity specific treatment, respectively. Study Design: This case control study is based on 100 confirmed cases of bacterial meningitis of pediatric age group with over the period of one year at General medicine ward, Children Hospital & Institute of Child Health, Faisalabad. Results: There was male predominance with M:F ratio of 1.4:1. Most of the patients (n=55) were ≤ 1 year of age. The main causative agents were S. pneumoniae, S. aureus, and S. epidermidis. A considerable number of patients were resistant to 3rd generation antibiotics including ceftriaxone R=77% (G+) R=41% (G-) and ceftazidime R=59% (G+), R=26% (G-). In terms of duration of hospital and ICU stay and condition at the time of discharge, case group (n=50) showed better prognosis. Conclusion : Early (