Antimicrobial Stewardship Barriers and Goals in Pediatric Oncology and Bone Marrow Transplantation: A Survey of Antimicrobial Stewardship Practitioners

2015 ◽  
Vol 37 (3) ◽  
pp. 343-347 ◽  
Author(s):  
Joshua Wolf ◽  
Yilun Sun ◽  
Li Tang ◽  
Jason G. Newland ◽  
Jeffrey S. Gerber ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Pediatric Oncology ◽  
Antimicrobial Stewardship ◽  
Geographic Location ◽  
Institutional Characteristics ◽  
Antimicrobial Use ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Barriers To Implementation ◽  
Location Strategies

We undertook a cross-sectional survey of antimicrobial stewardship clinicians in North America and Australasia regarding practices, goals, and barriers to implementation of stewardship for pediatric oncology patients. Goals and barriers were similar regardless of clinician or institutional characteristics and geographic location. Strategies addressing these factors could help optimize antimicrobial use.Infect. Control Hosp. Epidemiol. 2016;37(3):343–347

scholarly journals How far do we still need to go? A survey on knowledge, attitudes, practice related to antimicrobial stewardship regulations among Chinese doctors in 2012 and 2016

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e027687 ◽  
Author(s):  
Ruyu Xia ◽  
Xiaoyang Hu ◽  
Merlin Willcox ◽  
Xinxue Li ◽  
Yuxiu Li ◽  
...  
Keyword(s):  
Antimicrobial Stewardship ◽  
Secondary Outcome ◽  
Antimicrobial Use ◽  
Snowball Sampling ◽  
Cross Sectional Survey ◽  
Self Medication ◽  
Cross Sectional ◽  
Mobile Phone Application ◽  
Almost All ◽  
Positive Effect

ObjectivesTo explore doctors’ knowledge, willingness, concerns and the countermeasures to the most stringent antimicrobial stewardship regulations of China which implemented in August 2012.DesignCross-sectional survey. A pretested 32-point structured questionnaire was distributed to doctors by sending a web link via the mobile phone application WeChat through snowball sampling methods and email groups of medical academic societies.SettingChina.ParticipantsDoctors.Primary and secondary outcome measuresThe questionnaire inquired about the doctors’ experiences, knowledge, willingness, concerns and the countermeasures to the stewardship policies.ResultsTotal of persons in the groups was 19 791, among them 1194 submitted the answers, within them, 807 were doctors. Doctors had a mean age of 39.0 years. The majority (78.9% in 2012, 89.1% in 2016) reported that they were willing or very willing to accept the regulations. Almost all respondents (93.2%) felt the stewardship regulations had the potential to adversely affect the prognosis of patients who would have been prescribed antimicrobials before they were implemented, and >65% (65.7% in 2012, 66.9% in 2016) of doctors were often or always concerned about the prognosis of these patients. In 2012, 32% of doctors prescribed restricted antimicrobials or suggested patient self-medication with restricted antimicrobials to address doctors’ concerns, and this number decreased to 22.6% in 2016. Although compulsory antimicrobial stewardship training was frequent, less than half of respondents (46.8%) responded correctly to all three knowledge questions.ConclusionAntimicrobial stewardship regulations had some positive effect on rational antimicrobial use. Willingness and practice of doctors towards the regulations improved from 2012 to 2016. Knowledge about rational antimicrobial use was still lacking. Doctors found ways of accessing restricted antibiotics to address their concerns about the prognosis of patients, which undermined the implementation of the stewardship regulations.

scholarly journals Knowledge of Antimicrobial Resistance among Veterinary Students and Their Personal Antibiotic Use Practices: A National Cross-Sectional Survey

Antibiotics ◽  
2019 ◽  
Vol 8 (4) ◽  
pp. 243 ◽  
Author(s):  
Ismail A. Odetokun ◽  
Uduak Akpabio ◽  
Nma B. Alhaji ◽  
Khalid T. Biobaku ◽  
Nurudeen O. Oloso ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Antimicrobial Stewardship ◽  
Antibiotic Use ◽  
Antibiotic Usage ◽  
Descriptive Statistics ◽  
Antimicrobial Use ◽  
Cross Sectional Survey ◽  
Veterinary Students ◽  
Cross Sectional ◽  
Contributory Factors

The challenge of antimicrobial resistance (AMR) is grave in developing countries. Antimicrobials are misused yet stakeholders’ contribution to antimicrobial stewardship is low. Veterinary students are future prescribers and their knowledge could influence progress in combating AMR; hence, there is a need to assess their knowledge, attitude, and awareness of AMR. A multi-institutional questionnaire was administered to undergraduates in Nigerian veterinary schools. It comprised demographics, own personal antibiotic usage, and knowledge, attitude, and awareness of AMR in humans and animals. Descriptive statistics and logistic regression were used for analyses. Of the 426 respondents, 39.2% reported personal antimicrobial use in the previous six months. Over 60% received knowledge scores lower than average and >87% requested more education on clinical use and prescriptions pre-graduation, monitored dispensing of antimicrobials, conducting AMR research, and confirmed link among human, animal, and environmental health. Less than 25% of respondents were aware of antimicrobial stewardship and global efforts/organizations for AMR. Final year students have 9-fold and 14-fold more satisfactory knowledge on antimicrobials in humans and animals compared with other students, respectively (p = 0.001). Final year students also have more knowledge (13×) and awareness of contributory factors (3×) on AMR (p = 0.001) than other students. Unsatisfactory knowledge on AMR issues exists among veterinary students yet willingness to improve was observed. Identified knowledge, attitude, and gaps in AMR awareness should be targeted by veterinary schools in Nigeria.

scholarly journals Implementation of Infection Prevention and Antimicrobial Stewardship in Cardiac Electrophysiology Laboratories: Results from the SHEA Research Network

2017 ◽  
Vol 38 (4) ◽  
pp. 496-498 ◽  
Author(s):  
Preeti Mehrotra ◽  
Kalpana Gupta ◽  
Judith Strymish ◽  
Daniel B. Kramer ◽  
Anne Lambert-Kerzner ◽  
...  
Keyword(s):  
Antimicrobial Stewardship ◽  
Cardiac Electrophysiology ◽  
Infection Prevention ◽  
Research Network ◽  
Antimicrobial Use ◽  
Cross Sectional Survey ◽  
Cross Sectional

Infection prevention in electrophysiology (EP) laboratories is poorly characterized; thus, we conducted a cross-sectional survey using the SHEA Research Network. We found limited uptake of basic interventions, such as surveillance and appropriate peri-procedural antimicrobial use. Further study is needed to identify ways to improve infection prevention in this setting.

scholarly journals Perspectives of future pharmacists on the potential for development and implementation of pharmacist prescribing in Qatar

2020 ◽  
Vol 42 (1) ◽  
pp. 110-123
Author(s):  
Mohammad Issam Diab ◽  
Angham Ibrahim ◽  
Oraib Abdallah ◽  
Alla El-Awaisi ◽  
Monica Zolezzi ◽  
...  
Keyword(s):  
Focus Group ◽  
Treatment Options ◽  
Developed Countries ◽  
Focus Group Discussions ◽  
Cross Sectional Survey ◽  
Group Discussions ◽  
Cross Sectional ◽  
Pharmacist Prescribing ◽  
Barriers To Implementation ◽  
Special Training Program

AbstractBackground Pharmacists in many developed countries have been granted prescribing authorities under what is known as “non-medical prescribing” or “pharmacist prescribing”. However, such prescribing privileges are not available in many developing countries. Objective The objective of this study was to determine the perspectives of future pharmacists (recent pharmacy graduates and pharmacy students) on pharmacist prescribing and its potential implementation in Qatar. Methods A convergent parallel mixed-methods design was used: (1) a cross-sectional survey using a pre-tested questionnaire and; (2) focus group discussions to allow for an in-depth understanding of the issue, with a focus on pharmacists prescribing competencies as well as barriers for its implementation. Main outcome measures Future pharmacists’ perspectives and attitudes towards pharmacist prescribing in Qatar. Results The majority of the respondents (94.4%) indicated awareness of the prescribing competency related to selecting treatment options. Furthermore, the majority (92.4%) believed that pharmacists should undergo prescribing training and accreditation before been legally allowed to prescribe, a point that was reiterated in the focus group discussions. Participants generally expressed support for collaborative and supplementary prescribing models when developing prescribing frameworks for Qatar. Four categories emerged under the theme barriers to implementation of pharmacist prescribing: lack of prescribing competency, pharmacist mindset, lack of accessibility to patient records and counseling rooms, and diversity of education and training background. Conclusion The majority of recent pharmacy graduates and students were in favor of pharmacist prescribing been implemented in Qatar. However, a special training program was deemed necessary to qualify pharmacists to prescribe safely and effectively.

scholarly journals Antimicrobial stewardship program in China’s tertiary hospitals in 2018: a nationwide cross-sectional online survey

2020 ◽  
Author(s):  
Yue Zhou ◽  
Haishaerjiang Wushouer ◽  
Xi Zhang ◽  
Jiajia Feng ◽  
Likai Lin ◽  
...  
Keyword(s):  
Antimicrobial Stewardship ◽  
Evaluation System ◽  
Clinical Pathways ◽  
Popular Science ◽  
Outcome Evaluation ◽  
Antimicrobial Use ◽  
Cross Sectional ◽  
Prescription Audit ◽  
Stewardship Program ◽  
Tertiary Hospitals

Abstract Background The study aimed to assess the development of antimicrobial stewardship (AMS) program in China’s tertiary hospitals to identify the potential challenges for AMS program and provide references and benchmarks for strategic policymaking. Methods A nationwide cross-sectional study was conducted online by sending questionnaires to tertiary hospitals under China Antimicrobial Resistance Surveillance System (CARSS) between November 1, 2018 and December 10, 2018. The questionnaire included 5 sections regarding structure, technical support, antimicrobial use management, antimicrobial use surveillance and education. Descriptive statistics were used for data analysis. Results Of 1044 tertiary hospitals under CARSS, 13.4% (140) hospitals participated in the study. Among them, 99.3% (139/140) set up AMS program. Hospital president (82.1%, 115/140) and medical service department (59.3%, 83/140) were responsible for AMS outcomes in most hospitals. Structured antimicrobial formulary restriction management was adopted by 99.3% (139/140) hospitals. Infection disease department, infection control department and microbiological laboratories were established in 87.1% (122/140), 99.3% (139/140), and 100% (140/140) hospitals, respectively. Up to 85.6% (124/140) hospitals applied clinical pathways and 33.6% (47/140) hospitals implemented hospital-specific guidelines for infectious diseases. Outpatient prescription audit, inpatient prescription audit and prophylactic antimicrobial prescription audit of aseptic operation were performed in 99.3% (139/140), 98.6% (138/140) and 95.7% (134/140) hospitals, respectively. Up to 97.1% (136/140) hospitals participated in antimicrobial use surveillance network and 99.3% (139/140) hospitals established the specialized management of carbapenem and tigecycline. Staff education and AMS-related popular science education were provided with different ways and frequency in 100% (140/140) and 88.6% (124/140) hospitals, respectively. Conclusions AMS in China’s tertiary hospitals were primarily headed by hospital presidents and involved collaboration among various disciplines and administrative departments. More efforts should be put into further promoting and strengthening the development of hospital-specific guidelines and the establishment of progress and outcome evaluation system.

scholarly journals Antimicrobial use and resistance in Escherichia coli from healthy food-producing animals in Guadeloupe

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Gaëlle Gruel ◽  
Arantxa Sellin ◽  
Hélène Riveiro ◽  
Matthieu Pot ◽  
Sébastien Breurec ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Beef Cattle ◽  
Antimicrobial Use ◽  
Cross Sectional Survey ◽  
Isolation And Identification ◽  
Cross Sectional ◽  
Rational Use ◽  
E Coli ◽  
Field Samples ◽  
Polymerase Chain

Abstract Background Selection pressure exerted by use of antibiotics in both human and veterinary medicine is responsible for increasing antimicrobial resistance (AMR). The objectives of this study were to better understand antimicrobial use in pigs, beef cattle, and poultry on farms on Guadeloupe, French West Indies, and to acquire data on AMR in Escherichia coli in these food-producing animals. A cross-sectional survey was conducted at 45 farms on Guadeloupe, and practical use of antimicrobials was documented in declarative interviews between March and July 2018. A total of 216 fecal samples were collected between January 2018 and May 2019, comprising 124 from pigs, 75 from beef cattle, and 17 from poultry litter. E. coli isolates were obtained for further testing by isolation and identification from field samples. Antimicrobial susceptibility testing and screening for blaCTX-M, blaTEM, tetA, and tetB resistance genes by polymerase chain reaction on extracted genomic DNA were performed. Results The study showed rational use of antimicrobials, consisting of occasional use for curative treatment by veterinary prescription. Tetracycline was the most commonly used antimicrobial, but its use was not correlated to E. coli resistance. Extended-spectrum β-lactamase (ESBL) E. coli isolates were detected in 7.3% of pigs, 14.7% of beef cattle, and 35.3% of poultry. blaCTX-M-1 was the predominant gene found in ESBL-E. coli isolates (68.8%), followed by blaCTX-M-15 (31.3%). Conclusion Despite rational use of antimicrobials, the rate of ESBL-E. coli in food-producing animals in Guadeloupe, although moderate, is a concern. Further studies are in progress to better define the genetic background of the ESBL-E. coli isolates. Graphical abstract

Fertility preservation in children newly diagnosed with cancer: Existing standards of practice in Australia and New Zealand

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 9047-9047
Author(s):  
J. A. Heath ◽  
C. J. Stern
Keyword(s):  
New Zealand ◽  
Fertility Preservation ◽  
Pediatric Oncology ◽  
North American ◽  
Ethical Issues ◽  
Ovarian Tissue ◽  
Newly Diagnosed ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
And Storage

9047 Background: Over the past two decades, rapid advances have occurred in both the successful treatment of childhood cancers and reproductive medicine. We sought to establish the current level of clinical practice for sperm, oocyte and gonadal tissue collection and storage in children newly diagnosed with cancer in Australia and New Zealand (ANZ). Methods: A cross-sectional survey of all pediatric oncology services in ANZ was performed. Comparisons to recently published North American practices and to current recommendations for best practice were also made. Results: Of the 13 centers invited to participate, 12 (92%) completed the survey. All centers had offered sperm conservation, but only ten (83%) had offered oocyte/ovarian tissue conservation. Available methods of gamete collection and storage were not consistent. Two centers were using GnRH agonists as fertility protection in post-pubertal females. Forty-two per cent had offered fertility conservation to males and females prior to completion of sexual development. All centers were more likely to offer sperm conservation than oocyte conservation for any given disease. The most common diseases for which conservation was offered were lymphomas and sarcomas. The anticipated cumulative dose at which centers elected to offer fertility preservation varied widely, both for the alkylator cyclophosphamide (1g/m2 to 10g/m2) and for abdominal/pelvic irradiation (any to 12 Gy) and spinal irradiation (any to 18Gy). Fertility counseling was offered in a variety of settings by 82% of centers. Despite 92% of centers agreeing that fertility preservation guidelines would be helpful, only two (17%) had any in place. Overall, there was greater uptake and consistency of utilization of fertility services in ANZ when compared with published North American data. Conclusions: There are inconsistencies regarding the indications for and methods of gamete conservation in pediatric oncology centers throughout ANZ. Unresolved medical, legal and ethical issues suggest the development of guidelines and a voluntary code of practice would be helpful. No significant financial relationships to disclose.

Practices to Improve Antimicrobial Use at 47 US Hospitals the Status of the 1997 SHEA/IDSA Position Paper Recommendations

2000 ◽  
Vol 21 (4) ◽  
pp. 256-259 ◽  
Author(s):  
Rachel M. Lawton ◽  
Scott K. Fridkin ◽  
Robert P. Gaynes ◽  
John E. McGowan ◽  
Keyword(s):  
Infectious Disease ◽  
Position Paper ◽  
Antimicrobial Use ◽  
Cross Sectional Survey ◽  
Phase 3 ◽  
Infectious Disease Physician ◽  
Cross Sectional ◽  
Antimicrobial Prescribing ◽  
The Status ◽  
Healthcare Epidemiology

Objective.To determine the status of programs to improve antimicrobial prescribing at select US hospitals.Design:Cross-sectional survey.Participants and Setting:Pharmacy and infection control staff at all 47 hospitals participating in phase 3 of Project Intensive Care Antimicrobial Resistance Epidemiology.Results:All 47 hospitals had some programs to improve antimicrobial use, but the practices reported varied considerably. All used a formulary, and 43 (91%) used it in conjunction with at least one of the other three antimicrobial-use policies evaluated: stop orders, restriction, and criteria-based clinical practice guidelines (CPGs). CPGs were reported most commonly (70%), followed by stop orders (60%) and restriction policies (40%). Although consultation with an infectious disease physician (70%) or pharmacist (66%) was commonly used to influence initial antimicrobial choice, few (40%) reported a system to measure compliance with these consultations.Conclusions:In most hospitals surveyed, practices to improve antimicrobial use, although present, were inadequate based on recommendations in a Society for Healthcare Epidemiology of America and Infectious Disease Society of America joint position paper. There is room to improve antimicrobial-use stewardship at US hospitals.

Sign in / Sign up

Export Citation Format

Share Document