Implementation and outcomes of an advanced antimicrobial stewardship program at a quaternary care hospital in the United Arab Emirates

Dr Shafi Mohammed1

1Cleveland Clinic Abu Dhabi, ,


The implementation of an advanced antimicrobial stewardship program at a quaternary care hospital in the UAE is described, including a report on the implementation and outcomes of the program.


This was a single-center quasi-experimental study to assess the impact of the ASP on Antimicrobial use measures, ASP interventions performed, and clinical outcomes by comparing the data collected at baseline, from the 3rd quarter 1 July 2015 to the fourth quarter  of 31 December 2017, approximately 2 years following program implementation.


From 1 July 2015 until 31 December 2017, the program reported a total direct cost savings estimated at $1 339 499. The antimicrobial cost per inpatient-day decreased by 32% from $47.2 to $32.3. Hospital-onset Clostridium difficile infection rates decreased from 0.46 cases/ 1000 patient days in 2015 to 0.12 cases/ 1000 patient days in 2017 (P = 0.035, 95% CI 0.08 to 0.91). Hospital-onset infections due to multidrug-resistant organisms decreased from 2.39 cases/ 1000 patient days in 2015 to 0.38 cases per 1000 patient days in 2017 (P = 0.05, 95% CI 0.09 to 0.28).

Overall, the number of ASP interventions amounted to a total of 4123 interventions, with an acceptance rate of 91%.


The implementation of an advanced ASP at a quaternary care hospital in the UAE was associated with a decrease in antimicrobial utilization, antimicrobial expenditure, and a reduction in hospital-onset CDI and MDRO rates.


Dr. Shafi Mohammed, DNP MPH CIC FRSPH, serves as a Senior Director of Infection Prevention & Control and Occupational Health Medicine at Cleveland Clinic Abu Dhabi and a co-chair of Cleveland Clinic Abu Dhabi Infection Control Committee. He holds positions as member of APIC Board of Directors  and Alliance for Prudent Use of Antibiotics, Antibiotics Resistance Working Group under Health Authority Abu Dhabi.

He earned his doctorate from Case Western Reserve University;  an MPH, Post-graduate certificates in Health Promotion, Infection Prevention and Control and Research ; a fellow of Royal Society of Public Health UK.

From 2009 – 2012, he served as managing director of Fleming Healthcare Ltd in the UK, Head of Infection Control Services at Ealing National Health Service Hospital, UK;  Education Officer for Infection Prevention Society, North West London branch, Peer Reviewer for NHS Health Care Associated Infections Peer Review Group for London.


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