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

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.

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Cognizance and Intervention of a Pharmacist in Antimicrobial Stewardship Program among Students of Health Care Professionals, a Cross Sectional Study

MOJ Bioequivalence & Bioavailability ◽

10.15406/mojbb.2017.03.00024 ◽

2017 ◽

Vol 3 (1) ◽

Author(s):

Syeda Sarah Abbas

Keyword(s):

Health Care ◽

Antimicrobial Stewardship ◽

Health Care Professionals ◽

Cross Sectional Study ◽

Antimicrobial Stewardship Program ◽

Sectional Study ◽

Cross Sectional ◽

Stewardship Program

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PRACTICES AND PERCEPTION OF NIGERIAN COMMUNITY PHARMACISTS TOWARDS ANTIMICROBIAL STEWARDSHIP PROGRAM

International Journal of Pharmacy and Pharmaceutical Sciences ◽

10.22159/ijpps.2020v12i4.36505 ◽

2020 ◽

pp. 37-42 ◽

Cited By ~ 2

Author(s):

USMAN ABUBAKAR

Keyword(s):

Antimicrobial Stewardship ◽

Community Pharmacists ◽

Cross Sectional Study ◽

Antimicrobial Stewardship Program ◽

Median Score ◽

Questionnaire Response ◽

Job Status ◽

Cross Sectional ◽

Good Practices ◽

Stewardship Program

Objective: Community pharmacists have an important role in promoting the appropriate use of antibiotics. There is a paucity of data describing the contributions of community pharmacists in antimicrobial stewardship program (ASP) in Nigeria. This study evaluated the practices and perceptions of community pharmacists towards ASP. Methods: This was a cross-sectional study conducted among community pharmacists in two cities in Northern Nigeria: Minna and Kaduna, using a 30-item validated and pre-tested questionnaire. Data collected between April and May 2019 and analyzed using SPSS version 23. Results: Of 130 community pharmacists, 98 completed and returned the questionnaire (response rate: 75.3%). More than 90% strongly agreed/agreed that ASP is important to reduce inappropriate use of antibiotics and antibiotic resistance, improve patient’s clinical outcomes. However, lack of training (56.1%), lack of cooperation from physicians (61.2%) and lack of access to patient records (66.8%) were identified as barriers to community pharmacists’ involvement in ASP. Overall, community pharmacists had good practices (median score: 3.5; IQR: 1–5) and positive perceptions (median score: 4.0; IQR: 3–5) towards ASP. Job status and dispensing antibiotics without prescription were significantly associated with practice, while age and job status were associated with perception towards ASP. Conclusion: Community pharmacists demonstrated good practices and positive perceptions towards ASP. However, lack of training and lack of cooperation from prescribers limit their involvement in the program. Training of community pharmacists in antimicrobial stewardship and inter-professional collaboration are recommended.

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Utilization of Antibiotic Prophylaxis in Three Common Abdominal Surgeries, Adherence to Standard Guidelines and Surgeons' Perception in Teaching Hospitals, Islamabad, Pakistan

10.20944/preprints201906.0119.v1 ◽

2019 ◽

Cited By ~ 2

Author(s):

Zakir Khan ◽

Naveed Ahmed ◽

Asim ur Rehman ◽

Faiz ullah Khan ◽

Hazir Rahman

Keyword(s):

Antimicrobial Stewardship ◽

Phase 1 ◽

Antibiotic Use ◽

Correct Choice ◽

Teaching Hospitals ◽

Antimicrobial Stewardship Program ◽

Appropriate Use ◽

Cross Sectional ◽

Validated Questionnaire ◽

Stewardship Program

Background and objectives: The appropriate use of antibiotics is the main strategy of Antimicrobial stewardship program. This study was planned to evaluate the quality of antibiotic prescriptions, its adherence with standard guidelines and surgeons’ perception regarding antibiotic use in surgeries. Methods: A prospective cross-sectional observational and survey-based study comprised of two sections: Phase 1; to investigate the antibiotic utilization in three most common abdominal surgical procedures during 9 months (January 2017 to September 2017). The appropriateness of antibiotics was compared with evidence-based guidelines. Phase 2; the surgeon’s perspectives were evaluated through a self-administered questionnaire (13 items) during the next three months (October 2017 to December 2017). Descriptive statistics, chi-square and Fisher’s exact tests analysis were used through SPSS Statistical Package 21.0. Results: A total of 866 eligible surgical cases out of 1015 were investigated. An acute appendectomy (n= 418; 48.2%) was most common surgical intervention followed by laparoscopic cholecystectomy (n= 278; 32.1%) and inguinal hernia (n= 170; 19.7%). About 97.5% of patients received antibiotics. Among these, 9.5% adhered according to guidelines with respect to correct choice, 40% for timing, 100% for dose and route (optimal value 100%). The ceftriaxone (J01XD04; n= 503; 59.5%) was most frequently prescribed antibiotic. A 200 participants (response rate 70.6%) filled out a validated questionnaire (internal consistency; α ≥ 0.7). One hundred and thirty-eight (69%) reported the overuse of antibiotics and most of them (97%) preferred broad-spectrum antibiotics instead of narrow-spectrum. The participants reported that non-availability hospital-based guidelines (n=193; 96.5%), prescribing of antibiotics without guidelines (n=186; 93%), underestimation of infection (n=177; 88.5%), lack of consensus (n=135; 67.5%) and poor awareness about guidelines (n=122; 61%) were the main determinants in their health care settings. Conclusions: The compliance of Surgical antibiotic was far below the recommendations of guidelines. The urgent needs of awareness among surgeons and implementation of antimicrobial stewardship program were important recommended interventions for appropriate use antibiotics.

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Physicians’ attitudes on the implementation of an antimicrobial stewardship program in Lebanese hospitals

Pharmacy Practice ◽

10.18549/pharmpract.2021.1.2192 ◽

2021 ◽

Vol 19 (1) ◽

pp. 2192

Author(s):

Nathalie Sayegh ◽

Souheil Hallit ◽

Rabih Hallit ◽

Nadine Saleh ◽

Rouba K. Zeidan

Keyword(s):

Antimicrobial Stewardship ◽

Audit And Feedback ◽

Antimicrobial Stewardship Program ◽

National Guidelines ◽

Cross Sectional Survey ◽

Online Questionnaire ◽

Cross Sectional ◽

Positive Attitudes ◽

Stewardship Program ◽

Prospective Audit And Feedback

Background: Misuse of antibiotics and antimicrobial resistance are global concerns. Antibiotic stewardship programs (ASP) are advocated to reduce pathogens resistance by ensuring appropriate antimicrobial use. Several factors affect the implementation of ASPs in hospitals. The size and types of care provided, as well as the complexity of antibiotic prescription, are all issues that are considered in designing an effective hospital-based program. Objectives: To examine physicians’ attitude on implementation of an antimicrobial stewardship program in Lebanese hospitals. Methods: A descriptive cross-sectional survey was carried out using an online questionnaire. Survey items assessed ASP implementations, physicians’ attitudes, usefulness of the tools, and barriers of implementation. The questionnaire was based on the Center for Disease Control core-elements. Results: 158 physicians completed the survey with a response rate of 4%. Our results showed that the majority (66%) of physicians were familiar with the ASP concept. Most respondents reported a lack of regular educational programs (41%), as well as a lack of support from the medical staff (76%). This study demonstrated positive attitudes and support for ASP implementation. However, ASPs were reported as affecting physicians’ autonomy by 34 % of the participants. Antibiotic rounds and prospective audit and feedback were rated as most useful interaction methods with the ASPs. A minimal support of the Ministry Of Public Health, as well as the absence of regulation and of national guidelines, were reported as barriers to ASPs. The shortage of Infectious Disease physicians was seen as a barrier by half of the respondents. Conclusions: Physicians are supportive of ASP, with preference for interventions that provide information and education rather than restrictive ones. Additional research is needed on a larger sample of physicians.

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IMPLEMENTING AN ANTIMICROBIAL STEWARDSHIP PROGRAM IN A TERTIARY UNIVERSITY PEDIATRIC HOSPITAL IN SPAIN

10.26226/morressier.58fa1764d462b80290b509f8 ◽

2017 ◽

Author(s):

Maria Fernanda Guzman Monagas

Keyword(s):

Antimicrobial Stewardship ◽

Antimicrobial Stewardship Program ◽

Pediatric Hospital ◽

Stewardship Program

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Sustainability Failure in the Antimicrobial Stewardship Program in a Secondary Care Hospital from Cuba: A Historical Review of 30 Years and 3 Shots

Anti-Infective Agents ◽

10.2174/2211352518999200706014401 ◽

2020 ◽

Vol 18 ◽

Author(s):

Humberto Guanche Garcell ◽

Juan José Pisonero Socias ◽

Gilberto Pardo Gómez

Keyword(s):

Antimicrobial Stewardship ◽

Historical Review ◽

Original Data ◽

Care Hospital ◽

Antimicrobial Stewardship Program ◽

Continuous Quality ◽

Stewardship Program ◽

History Of ◽

Health Organization

Background: During the last 30 years an antimicrobial stewardship program (ASP) was implemented in a facility with periods of weakness. We aim to describe the history of the sustainability failure in the local ASP. Methods: A historical review was conducted using original data from the facility library and papers published. An analysis of factors related to the failure was conducted based on the Doyle approach. Results: The first ASP was implemented from 1989 to 1996 based on the international experiences and contributes to the improvement in the quality of prescription, reduction of 52% in cost and in the incidence of nosocomial infection. The second program restarts in 2008 and decline in 2015, while the third program was guided by the Pan-American Health Organization from 2019. This program, in progress, is more comprehensive than previous ones and introduced as a novel measure the monitoring of antibiotic prophylaxis in surgery. The factors related to the sustainability were considered including the availability of antimicrobials, the leader´s support, safety culture, and infrastructure. Conclusions: The history behind thirty years of experiences in antimicrobial stewardship programs has allowed us to identify the gaps that require proactive strategies and actions to achieve sustainability and continuous quality improvement.

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