Introducing an antibiotic stewardship program in a humanitarian surgical hospital

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

Research output: Contribution to journalArticle


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

Original languageEnglish (US)
JournalAmerican Journal of Infection Control
Publication statusAccepted/In press - 2016



  • Antibiotic resistance
  • Antimicrobial stewardship
  • Bacterial infections
  • Chronic osteomyelitis
  • Developing countries
  • Low- and middle-income countries
  • Reconstructive surgery
  • Resource-limited settings
  • Trauma surgery
  • War surgery

ASJC Scopus subject areas

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

Cite this

Bhalla, N., Hussein, N., Atari, M., Fakhri, R. M., Lepora, C., Walsh, N., ... Murphy, R. A. (Accepted/In press). Introducing an antibiotic stewardship program in a humanitarian surgical hospital. American Journal of Infection Control.