Current status of antimicrobial stewardship programmes in Korean hospitals: results of a 2018 nationwide survey

Kim, B.; Lee, M.J.; Moon, Song Mi; Park, S.Y.; Song, Kyoung-Ho; Lee, Hyeongrae; Park, J.S.; Lee, M.S.; Choi, Su Mi; Yeom, Joon‐Sup; Kim, J.Y.; Kim, C.-J.; Chang, Hyun Ha; Kim, E.S.; Kim, T.H.; Kim, H.B.

doi:10.1016/j.jhin.2019.09.003

Cited by 40 publications

(35 citation statements)

References 25 publications

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“…15 Several studies pointed out that the lack of manpower is one of the main barriers to implementing an ASP. 8,16 Although human resources are an important factor for ASP operations, many hospitals in Asia do not have adequate personnel to make up a proper ASP team. 17 In Korea, the ASPs in hospitals are primarily carried out by 1 or 2 infectious diseases physicians, and the participation of other medical personnel such as clinical pharmacists and other specialists is still lacking.…”

Section: Discussionmentioning

confidence: 99%

“…(1) Appropriate antibiotics recommendations for patients with suspected infections without a proven site of infection or causative pathogens (2) Appropriate antibiotics recommendations for patients with suspected infections without a proven site of infection but with causative pathogens (3) Appropriate antibiotics recommendations for patients with suspected infections with a proven site of infection but without causative pathogens (4) Appropriate antibiotics recommendations for patients with suspected infections with a proven site of infection and causative pathogens (5) Review and approval of designated antibiotics under restrictive measures (6) Avoidance of inappropriate combinations of antibiotic therapy (7) Parenteral to oral conversion (8) Review of therapy for appropriate duration, appropriate dosage, or drug-drug interaction (9) Review of surgical prophylactic antibiotics (10) Other.…”

Section: Definition Of Major Asp Activitiesmentioning

confidence: 99%

“…7 Unfortunately, in most Korean hospitals, ASPs are carried out by only 1 or 2 infectious diseases specialists. 8 According to the Infectious Disease Society of America's guidelines, each hospital should have an antimicrobial stewardship team infectious diseases physician and clinical pharmacist with infectious diseases training, and both of these individuals should dedicate enough time for ASP activities. 4 However, an acceptable staffing standard for an ASP team is currently unclear.…”

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confidence: 99%

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Human resources required for antimicrobial stewardship activities for hospitalized patients in Korea

Park

Chang

Kim

et al. 2020

Infect. Control Hosp. Epidemiol.

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Objectives: We calculated the human resources required for an antimicrobial stewardship program (ASP) in Korean hospitals. Design: Multicenter retrospective study. Setting: Eight Korean hospitals ranging in size from 295 to 1,337 beds. Methods: The time required for performing ASP activities for all hospitalized patients under antibiotic therapy was estimated and converted into hours per week. The actual time spent on patient reviews of each ASP activity was measured with a small number of cases, then the total time was estimated by applying the determined times to a larger number of cases. Full-time equivalents (FTEs) were measured according to labor laws in Korea (52 hours per week). Results: In total, 225 cases were reviewed to measure time spent on patient reviews. The median time spent per patient review for ASP activities ranged from 10 to 16 minutes. The total time spent on the review for all hospitalized patients was estimated using the observed number of ASP activities for 1,534 patients who underwent antibiotic therapy on surveillance days. The most commonly observed ASP activity was ‘review of surgical prophylactic antibiotics’ (32.7%), followed by ‘appropriate antibiotics recommendations for patients with suspected infection without a proven site of infection but without causative pathogens’ (28.6%). The personnel requirement was calculated as 1.20 FTEs (interquartile range [IQR], 1.02–1.38) per 100 beds and 2.28 FTEs (IQR, 1.93–2.62) per 100 patients who underwent antibiotic therapy, respectively. Conclusion: The estimated time required for human resources performing extensive ASP activities on all hospitalized patients undergoing antibiotic therapy in Korean hospitals was ~1.20 FTEs (IQR, 1.02–1.38) per 100 beds.

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Section: Discussionmentioning

confidence: 99%

Section: Definition Of Major Asp Activitiesmentioning

confidence: 99%

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confidence: 99%

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Human resources required for antimicrobial stewardship activities for hospitalized patients in Korea

Park

Chang

Kim

et al. 2020

Infect. Control Hosp. Epidemiol.

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“… 6 16 Unfortunately, very few Korean hospitals perform monitoring and intervention for high-risk antimicrobials for CDI. 18 Therefore, it is necessary to implement antimicrobial stewardship program interventions targeting high-risk antibiotics for CDI in Korean hospitals.…”

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confidence: 99%

Association between Antibiotic Consumption and Incidence of Clostridioides difficile Infection in a Hospital

Kim

Pai

2020

J Korean Med Sci

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Previous exposure to antimicrobials is a major risk factor for Clostridioides difficile infection (CDI). Antibiotic prescription and C. difficile toxin assay records of patients admitted to a tertiary hospital in Korea from 2009 to 2013 were collected to investigate the association between antibiotic consumption and CDI incidence. A Spearman's correlation analysis between CDI incidence (positive result of toxin assay/10,000 admissions) and antibiotic consumption (defined daily dose/1,000 patient-days) was performed on a monthly basis. Using the matched month approach, we found a significant correlation between CDI rate and moxifloxacin consumption (Spearman's r = 0.351, P < 0.001). Furthermore, using the onemonth delay approach, we found that the consumption of clindamycin (Spearman's r = 0.272, P = 0.037) and moxifloxacin (Spearman's r = 0.297, P = 0.022) was significantly correlated with CDI incidence. Extended-spectrum cephalosporins did not have any effect on CDI incidence.

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“…First, the composition of the expert panel was limited to some specialties. Even though infectious diseases specialists are key personnel in antimicrobial stewardship programs in Korean hospitals, 13 the participation of other stakeholders should have been encouraged. Second, the surveys were administered online without face to face meetings, and this might have disturbed the communication among the panel.…”

mentioning

confidence: 99%

Development of Antibiotic Classification for Measuring Antibiotic Usage in Korean Hospitals Using a Modified Delphi Method

et al. 2020

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In 2019, a project designed to develop a system for measuring and comparing antibiotic usage in hospitals was launched in Korea. As part of this project, we developed a means to classify antibiotic usage in Korean hospitals using a modified Delphi method. In results, the following categories of antibiotic classification were accepted for use in Korean hospitals: 1) broad-spectrum antibacterial agents predominantly used for hospital-onset infections in adults, 2) broad-spectrum antibacterial agents predominantly used for community-acquired infections in adults, 3) antibacterial agents predominantly used for resistant gram-positive infections in adults, 4) narrow-spectrum beta-lactam agents in adults, 5) antibacterial agents predominantly used for extensive antibiotic resistant gram-negative bacteria in adults, and 6) total antibacterial agents.

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Current status of antimicrobial stewardship programmes in Korean hospitals: results of a 2018 nationwide survey

Cited by 40 publications

References 25 publications

Human resources required for antimicrobial stewardship activities for hospitalized patients in Korea

Human resources required for antimicrobial stewardship activities for hospitalized patients in Korea

Association between Antibiotic Consumption and Incidence of Clostridioides difficile Infection in a Hospital

Development of Antibiotic Classification for Measuring Antibiotic Usage in Korean Hospitals Using a Modified Delphi Method

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