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Implementing an Infectious Disease and Antimicrobial Stewardship Program to Support the Treatment of Hospital-Acquired Infections in Conflict-Associated Casualties in Ukraine

Published online by Cambridge University Press:  21 May 2025

Hailie D Uren Open the ORCID record for Hailie D Uren [Opens in a new window] ,
Nataliia Aliieva Open the ORCID record for Nataliia Aliieva [Opens in a new window]  and
Eric Weinstein Open the ORCID record for Eric Weinstein [Opens in a new window]
Hailie D Uren
Affiliation:
The First Medical Union of the City of Lviv, Lviv, Lviv, Ukraine
Nataliia Aliieva
Affiliation:
The First Medical Union of the City of Lviv, Lviv, Lviv, Ukraine
Eric Weinstein
Affiliation:
CRIMEDIM, Novara, Piemonte, Italy University of South Florida, Tampa, Florida, United States
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Abstract

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Background/Introduction:

Since the start of the full-scale military invasion of Ukraine by the Russian Federation in 2022, Ukrainian hospitals have been operating under surge capacity - working relentlessly to manage the tidal wave of war-wounded patients. Retrospective analysis of war-wounded casualty surgical admissions in a reconstructive hospital along the Trauma Pathway shows that 90% of casualties present with severe tissue and bone infections, due to sub-optimal surgical interventions, IPC measures and antibiotic usage in the Trauma Stabilization Points and secondary hospitals. Life-saving strategies predominately center around re-amputation with long durations of antibiotics, resulting in long length of hospital stay, excess morbidity and mortality, and delayed progression to rehabilitation.

Objectives:

To support the implementation and evaluation of an infectious disease and antimicrobial stewardship program in a surgical department in a reconstructive hospital along the Ukrainian Trauma Pathway

Method/Description:

An INGO supported the Ukrainian tertiary hospital to implement “Antimicrobial stewardship programs in health-care facilities in low-and middle-income countries: a WHO practical toolkit”

Results/Outcomes:

The following results were evaluated from March 2023 to September 2023:

  • The average duration of antibiotics reduced from 5.18 days to 3.92 days

  • The average cost of antibiotics per patient reduced from $31.2 to $19.33 USD and cost of surgical prophylaxis antibiotics per patient reduced from $4.87 to $3.17 USD

Conclusion:

Implementing an Antimicrobial Stewardship and Infectious Disease Program in a surgical department of a tertiary hospital could support the quicker movement of patients to rehabilitation, reduce cost to the health facility and support clinicians to more effectively treat war-wounded patients in a conflict zone.

Information

Type
Meeting Abstracts
Information
Prehospital and Disaster Medicine , Volume 40 , Supplement S1: Abstracts of the World Health Organization (WHO) 6th Emergency Medical Teams (EMT) Global Meeting 2024 , May 2025 , pp. s46 - s47
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Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of World Association for Disaster and Emergency Medicine