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.
Prescription audit
