Introducing an antibiotic stewardship program in a humanitarian surgical hospital

Naina Bhalla, Nagham Hussein, Maha Atari, Rasheed M. Fakhri, Chiara Lepora, Nadia Walsh, Sara E. Cosgrove, Richard A. Murphy

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Antibiotic stewardship program (ASP) implementation in humanitarian settings is a new endeavor. Doctors Without Borders/Médecins Sans Frontières introduced an ASP within a hospital in Amman, Jordan, where patients from Iraq, Syria, and Yemen with chronic, often multidrug-resistant, infections related to war are managed. Antibiotics were reviewed, and real-time recommendations were made to optimize choice, dose, duration, and route by a small team. Over the first year of implementation, acceptance of the ASP's recommendations improved. When compared with the year prior to implementation, antibiotic cost in 2014 declined considerably from approximately $252,077 (average, $21,006/month) to <$159,948 ($13,329/month), and a reduction in use of broad-spectrum agents was observed. An ASP in a humanitarian surgical hospital proved acceptable and effective, reducing antibiotic expenditures and use of broad-spectrum agents.

Original languageEnglish (US)
Pages (from-to)1381-1384
Number of pages4
JournalAmerican Journal of Infection Control
Issue number11
StatePublished - Nov 1 2016


  • Antimicrobial stewardship
  • antibiotic resistance
  • bacterial infections
  • chronic osteomyelitis
  • developing countries
  • low- and middle-income countries
  • reconstructive surgery
  • resource-limited settings
  • trauma surgery
  • war surgery

ASJC Scopus subject areas

  • Epidemiology
  • Health Policy
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases


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