Rationalizing the Use of Antimicrobials in Jordanian Public Hospitals

According to the World Health Organization (WHO), antimicrobial resistance (AMR) kills about 700,000 people worldwide annually, with the majority of those deaths occurring in developing countries. To address this health crisis, Jordan’s Ministry of Health (MOH) is implementing a National Action Plan (NAP) to combat AMR. The US Agency for International Development (USAID) Medicines, Technologies, and Pharmaceutical Services (MTaPS) Program designed the rational use of antimicrobials (RUA) program to help the MOH with the implementation of the NAP. In this program, clinical and administrative teams at MOH hospitals developed key protocols to update and standardize the use of antimicrobials for treatment and prophylaxis in selected priority clinical areas.

Stakeholder Engagement

Central and hospital-level teams discussing antimicrobial protocols during the RUA Workshop for Al Mafraq Hospital. Photo Credit: MTaPS Jordan

In October 2022, MTaPS provided governance support by engaging stakeholders from the Communicable Diseases Directorate, Institutional Development and Quality Control Directorate, Pharmacy and Clinical Pharmacy Directorate (PCPD), Nursing Directorate, Central Laboratories Directorate, the Allied Medical Professions Directorate, and the Procurement and Supply Directorate. MTaPS then engaged health facility antimicrobial stewardship (AMS) teams from Al Salt Hospital and Al Mafraq Governmental Hospital—to identify priority clinical areas for AMR interventions.

Identified Priority AMR Interventions

Surgical antibiotic prophylaxis protocols as well as urinary tract infections (UTI) management, were identified as priority areas. Following a series of successful technical workshops, MTaPS supported the hospital’s AMS teams to finalize the antibiotic prophylaxis and treatment protocol and submitted them to the MOH PCPD for final review. The Central Pharmacy and Therapeutics Committee approved these protocols, a huge step for institutionalization.

Ministerial Approval

His Excellency, Prof. Firas Al-Hawari, Minister of Health, approved the protocols for dissemination and institutionalizing implementation across the MOH.