Antibiotic stewardship program: clear indicators of good clinical practice should be set up!


We are soon celebrating the World Antibiotic Awareness Week (13-19 Nov.). On the occasion of this event we made some interviews with representatives of CEE-countries (where antibiotic misuse is still a big issue). Read our second interview, this time with Dr Vera Katalinic-Jankovic from the Croatian National Institute of Public Health.

Vera, the preparations in regard to the Antibiotic awareness week certainly are in full progress. How will you celebrate this week in your country/hospital?

On November, 17 we will organize an EAAD/WAAW symposium for medical doctors and pharmacists to discuss important topics in antimicrobial resistance, national guidelines and on antimicrobial therapy. On that occasion participants are given promotional leaflets, posters etc. to use in their offices, and pharmacies to help them get involved in patient education.
There is no registration fee for the symposium, which is financed by the Ministry of Health. We expect two to three hundred participants, who are encouraged to organize lectures or meetings in their own hospitals. This year an usb with a video clip based on the E. Kishon short story „The Antibiotic Relay Race“, will be distributed to the participants so that it could be used as introduction to local lectures and meetings. The Ministry of Health is also supporting a One Health/One Science Symposium on November 18, with AMR as the main topic, organized to celebrate 135 years of Faculty of Pharmacy and Biochemistry at the University of Zagreb.
Apart from these national symposia, local AMR symposia are organized in some other cities throughout November-December.
In the occasion of the WAAW we publish our national AMR results which are available on the web but are also distributed to all managers of health care institutions with an accompanying MoH letter asking them to organize a meeting in their institution in order to discuss national and local AMR figures. And a number of TV, radio and newspapers interviews will be given by our AMR experts.

What are your experience from the last years? Do such priority actions help to increase awareness?

Yes, awareness on AMR is higher – also the WAAW, being an international initiative, helps a lot. However, changes in antibiotic prescribing are still not satisfactory.

How hospitals in your country generally deal with this topic?

We have some elements of antibiotic stewardship programs in our hospitals, like lists of restricted antibiotics, to some extent restrictive antibiotic reporting, data on antibiotic consumption, monitoring the use of antibiotics for surgical prophylaxis for certain procedures etc., but the results need to be discussed in more detail and clear indicators of good clinical practice should be set up. This is now promoted also through patient safety programs.

What is the general significance of antibiotics in your country?
(prescription practices, change of awareness etc.)

We are facing problems with MDR organisms, however we still have some drug options left. The major drivers of overuse of antibiotics in hospitals are long stays of elderly people in acute care hospitals and therefore insufficient isolation capacity in hospitals, lack of well-defined consulting role of CM and ID doctors.


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Carola Timmel is journalist for print and radio and professional speaker. Her focus lies on the topic Medicine & Health.

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