Antimicrobial Stewardship Initiatives Throughout Europe: Proven Value for Money

Oberjé, E.; Tanke, Marit A.C.; Jeurissen, Patrick

doi:10.4081/idr.2017.6800

Cited by 24 publications

(21 citation statements)

References 20 publications

(17 reference statements)

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“…This is consistent with the twenty year experience of the Swedish STRAMA group where continuous dialogue with regional and local clinics, with audit and feedback recommendations based on local data, has been instrumental in achieving positive outcomes [47]. Similar experiences from the Netherlands suggest that effective surveillance and feedback by stewardship teams leads to more appropriate prescriptions, fewer infections, shorter hospital stays and less resistance [75]. One example of the importance of policy support is the Transatlantic Task Force on Antimicrobial Resistance established by the US and EU leaders in 2009 [76].…”

Section: Understanding the Drivers Behind Antibiotic Resistancesupporting

confidence: 78%

Prevention of antibiotic resistance – an epidemiological scoping review to identify research categories and knowledge gaps

Wall

2019

Global Health Action

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Background: Antibiotics have become the cornerstone for the treatment of infectious diseases and contributed significantly to the dramatic global health development during the last 70 years. Millions of people now survive what were previously life-threatening infections. But antibiotics are finite resources and misuse has led to antibiotic resistance and reduced efficacy within just a few years of introduction of each new antibiotic. The World Health Organization rates antibiotic resistance as a 'global security threat' impacting on global health, food security and development and as important as terrorism and climate change. Objectives: This paper explores, through a scoping review of the literature published during the past 20 years, the magnitude of peer-reviewed and grey literature that addresses antibiotic resistance and specifically the extent to which "prevention" has been at the core. The ultimate aim is to identify know-do gaps and strategies to prevent ABR. Methods: The review covers four main data bases, Web of Science, Medline, Scopus and Ebsco searched for 2000-17. The broader research field "antibiotic OR antimicrobial resistance" gave 431,335 hits. Narrowing the search criteria to "Prevention of antibiotic OR antimicrobial resistance" resulted in 1062 remaining titles. Of these, 622 were unique titles. After screening of the 622 titles for relevance, 420 abstracts were read, and of these 282 papers were read in full. An additional 53 references were identified from these papers, and 64 published during 2018 and 2019 were also included. The final scoping review database thus consisted of 399 papers. Results: A thematic structure emerged when categorizing articles in different subject areas, serving as a proxy for interest expressed from the research community. The research area has been an evolving one with about half of the 399 papers published during the past four years of the study period. Epidemiological modelling needs strengthening and there is a need for more and better surveillance systems, especially in lower-and middle-income countries. There is a wealth of information on the local and national uses and misuses of antibiotics. Educational and stewardship programmes basically lack evidence. Several studies address knowledge of the public and prescribers. The lessons for policy are conveyed in many alarming reports from national and international organizations. Conclusions: Descriptive rather than theoretical ambitions have characterized the literature. If we want to better understand and explain the antibiotic situation from a behavioural perspective, the required approaches are lacking. A framework for an epidemiological causal web behind ABR is suggested and may serve to identify entry points for potential interventions.

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Section: Understanding the Drivers Behind Antibiotic Resistancesupporting

confidence: 78%

Prevention of antibiotic resistance – an epidemiological scoping review to identify research categories and knowledge gaps

Wall

2019

Global Health Action

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“…The general goal of ABS is to ensure appropriate use of ABs, this entails cost effective use of AB which maximizes therapeutic effect while minimizing both drug related toxicity and ABR (WHO, 2011;Oberje et al, 2017). Among the goals of ABS asked in this survey, it is only increasing the use of AB that was rightly perceived by all the respondents not to be a goal of ABS.…”

Section: Discussionmentioning

confidence: 99%

Veterinary Medical Students’ Perceptions, Attitude and Knowledge about Antibiotic Resistance and Stewardship: How Prepared Are Our Future Prescribers?

et al. 2018

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A cross sectional, multicentre survey utilizing a questionnaire was used to assess 6 th -(final-) year veterinary medical students' perceptions, attitude and knowledge about antibiotic resistance (ABR) and stewardship (ABS) in 5 convenientlyselected veterinary schools in Nigeria. Data obtained were analyzed by Fischer's exact and χ 2 tests at a significance level of P < 0.05. Out of 175 final-year veterinary students, 95 (54.3% i.e., response rate) completed the survey. Of the 95, 17% have heard about ABS and 7% knew the meaning of ABS. Less than 10% knew the core principles and goals of ABS and less than 20% of the respondents knew the ideal members of an ABS team. All the respondents rightly knew that no antibiotic stewardship programme (ASP) exist in veterinary hospitals in Nigeria, nearly all of them (97%) reported that antibiograms are rarely used during antibiotic (AB) prescription in their institutional veterinary teaching hospital (VTH) and about two-third (65%) believed that ABs are overused in most veterinary hospitals in Nigeria. Most of the respondents believed that ABR is of greater concern at national level than in their institutional VTHs and majority of them (92%) believed that ABR is a global problem (P = 0.009). Minority of the respondents knew that inadequate personal hygiene, use of substandard ABs, prescription of ABs by non-veterinarians/professionals, poor infection control practices, treating self-limiting infections with ABs, suboptimal and incomplete AB doses (P = 0.017), are factors that promote ABR. Minority of the respondents knew that education on AB therapy (44%), development of antibiotic usage policies (35%), reduction of AB use (14%), establishment of national AB resistance surveillance (28%) and development of institutional guidelines for AB use (29%), are critical interventions to curb ABR. Only 17% of the respondents felt that their education on ABR is adequate for their veterinary career. Most of the respondents believed that strong knowledge of ABs is important for their future veterinary career and would like more education about ABR and ABS. Overall mean correct score of 29% on clinical knowledge vignettes with similar scores across the schools in all the areas, was recorded. This survey has shown that Nigerian veterinary students' perception and knowledge about ABR and ABS are poor and therefore creates doubt about their preparedness to practice ABS. There is urgent need for improved ABS education in Nigerian veterinary schools.

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“…This integral view is also supported by a recent review on diagnostic stewardship (10) with the examples of acute respiratory tract infections (7) and quinolone resistance (8). Thus, we strongly advocate the implementation of integrated stewardship programs as a standard approach to optimize patient management and patient care, increase cost-effectiveness, and address the urgent problem of rising antimicrobial resistance (2,9).…”

mentioning

confidence: 87%

Integrated Stewardship Model Comprising Antimicrobial, Infection Prevention, and Diagnostic Stewardship (AID Stewardship)

et al. 2017

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Antimicrobial Stewardship Initiatives Throughout Europe: Proven Value for Money

Cited by 24 publications

References 20 publications

Prevention of antibiotic resistance – an epidemiological scoping review to identify research categories and knowledge gaps

Prevention of antibiotic resistance – an epidemiological scoping review to identify research categories and knowledge gaps

Veterinary Medical Students’ Perceptions, Attitude and Knowledge about Antibiotic Resistance and Stewardship: How Prepared Are Our Future Prescribers?

Integrated Stewardship Model Comprising Antimicrobial, Infection Prevention, and Diagnostic Stewardship (AID Stewardship)

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