Implementasi Antimicrobial Stewardship Program di Kawasan Asia: Sebuah Kajian Sistematis

Antimicrobial Stewardship Program (ASP) is one of the recommended programs to optimize the prudent use of antimicrobials, particularly in the hospital settings. The successful ASP implementation is determined by numerous factors, including communication among healthcare workers, and the availability of human resources and facilities. There is limited evidence available regarding the ASP implementation in Asia, particularly in the low- and lower-middle income countries. This systematic review aimed to identify the type of ASP interventions implemented in Asian countries according to the income status and to describe the impact of ASP implementation on the clinical, microbiological, and financial outcomes. The search strategy was undertaken using PUBMED, and the search terms were “antimicrobial stewardship” and “Asia” which were combined with the use of a Boolean operator “AND”. In total, 28 articles from nine countries were included in the final review. No article from Indonesia could be found in this systematic review. There was only an article from a lower-middle income country that was conducted in a tertiary health institution. Most of the articles (22 articles) were from high-middle income countries and 18 of them were conducted either in the tertiary care or university affiliated hospitals. Prospective audit with intervention and feedback was the most frequent ASP used in which positive outcomes on the clinical, microbiological, and financial outcomes have been evidenced. The positive impact of ASP implementation should suggest the needs to initiate the program in the healthcare facilities in Indonesia while taking into account the available resources and the local cultures.