Antimicrobial Stewardship Knowledge, Attitudes, and Practices among Health Care Professionals at Small Community Hospitals

Abstract

Background Very little is known about antimicrobial stewardship knowledge, attitudes, and practices (KAP) among health care practitioners in small, community hospitals (SCHs) compared to large community hospitals (LCHs). Objective To compare infectious diseases (ID) clinical resources and describe KAP pertaining to antimicrobial stewardship among prescribers, pharmacists, and administrators from a large hospital network including a comparison between SCHs and LCHs. Methods An anonymous 48-item antimicrobial stewardship KAP survey was administered to pharmacists, prescribers, and administrators at 15 SCH (<200 beds) and 5 LCHs (>200 beds) within an integrated health care network. Results In total, 588 (14%) completed the survey: 198 from SCHs and 390 from LCHs. Most respondents were familiar or very familiar with the term antimicrobial stewardship and felt that antimicrobial stewardship was necessary. Most pharmacists and prescribers agreed that antimicrobials were overused at their hospital. However, SCH pharmacists and prescribers were more likely to disagree that antibiotic resistance is a significant problem locally. Pharmacists saw restrictions as a reasonable method of controlling antibiotic use more than prescribers. SCH practitioners were less familiar with IDSA guidelines and less likely to rely on ID specialists to a greater extent than LCH practitioners. Most respondents strongly agreed they would like more antimicrobial education. Conclusion SCH and LCH pharmacists, prescribers, and administrators are aware of antimicrobial resistance and overuse and agree that antimicrobial stewardship programs are necessary. SCHs are less likely to contact ID for information. These results support the development of antimicrobial stewardship programs at SCHs, while recognizing the significant differences in availability and utilization of resources.

Knowledge and Practice of Pharmacists toward Antimicrobial Stewardship in Pakistan

“…Approximately 80% of pharmacists were in favour and agreed that AMS programs improve patient care, which is aligned with the findings by Erku DA et al, where 86.3% of pharmacists were in favour of this. Research in other parts of the world also supports our findings that pharmacists and other health care professionals were in favour of an AMS program [46]. Similarly, AMS has been implemented in the majority of European countries in order to reduce the abuse and misuse of antimicrobials, the associated risk of resistance and adverse events [21] expenditure, the prevalence of resistant pathogens [47,48], and improve clinical outcomes [47,49].…”

Feasibility of Core Antimicrobial Stewardship Interventions in Community Hospitals

“…Almost 90% (74 of 84) of clinicians in our study hospitals who responded to the survey agreed that AS was important for patients; more than 55% (48 of 83) agreed that pharmacist antibiotic recommendations could improve the care of their patients. Buckel et al 14 polled pharmacists and prescribers at 20 community hospitals; both groups agreed that antimicrobials were overused in their hospitals. This increasing awareness of the importance of stewardship and acceptance of stewardship strategies in the community hospital setting is important.…”

Antibiotic Stewardship in Small Hospitals: Barriers and Potential Solutions

“…Previous surveys of smaller hospitals have shown that only 50%-58% of hospitals have access to ID physicians [28,29]. In Utah, only 1 of 15 small hospitals within the Intermountain network had access to an inpatient ID consultation in 2014 [30].…”