Development and Implementation of an Antimicrobial Stewardship Program in a Rural Hospital

Hogan, Kerry-Anne; Gazarin, Mohamed; Lapenskie, Julie

doi:10.4212/cjhp.v69i5.1595

Cited by 3 publications

(4 citation statements)

References 5 publications

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“…In the last few decades, the inappropriate use of antimicrobials and the rise of AMR has emerged as major global public health concern [5]. In an attempt to address the risks posed by AMR, the World Health Organization (WHO) recommends the initiation of antimicrobial stewardship programs (ASPs) to identify and monitor antimicrobial use and reduce the burden of AMR [6,7]. Economically developed countries have started implementing ASP to resolve this issue; however, in economically developing countries, the scenario is quite different.…”

Section: Introductionmentioning

confidence: 99%

Antimicrobial Usage and Resistance in Makkah Region Hospitals: A Regional Point Prevalence Survey of Public Hospitals

Haseeb

Faidah

Algethamy³

et al. 2021

IJERPH

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(1) Background: Inappropriate use of antimicrobials and subsequently rise of antimicrobial resistance (AMR) remains a major public health priority. Over-prescribing of broad-spectrum antibiotics is one of the main contributing factors for the emergence of AMR. We sought to describe antimicrobial prescribing trends among patients in public hospitals in Makkah hospitals. (2) Method: We undertook a point prevalence survey (PPS) in six hospitals in Makkah, Saudi Arabia, from January 2019 to July 2019. The survey included all the inpatients receiving antimicrobials on the day of PPS. Data was collected using the Global point prevalence survey (PPS) tool developed by the University of Antwerp, Belgium. (3) Results: Of 710 hospitalized patients, 447 patients (61.9%) were treated with one or more antimicrobials during the study period. The average bed occupancy among six hospitals was 74.4%. The majority of patients received antimicrobials parenterally (90.3%). Of the total prescribed antimicrobials, 415 (53.7%) antimicrobials were used in medical departments, 183 (23.7%) in surgical departments, and 175 (22.6%) in ICUs. Pneumonia (17.3%), skin and soft tissue infections (10.9%), and sepsis (6.6.%) were three common clinical indications. Ceftriaxones were the most commonly used antibiotics that were prescribed in 116 (15%) of patients, followed by piperacillin, with an enzyme inhibitor in 84 (10.9%). (4) Conclusion: There was a high prevalence of antibiotic use in the hospitals of Makkah, which could be a potential risk factor for the incidence of resistant strains, particularly MRSA infection. Public health decision-makers should take these findings into consideration to update national policies for antibiotic use in order to reduce the risks of further increases of AMR.

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Section: Introductionmentioning

confidence: 99%

Antimicrobial Usage and Resistance in Makkah Region Hospitals: A Regional Point Prevalence Survey of Public Hospitals

Haseeb

Faidah

Algethamy³

et al. 2021

IJERPH

View full text Add to dashboard Cite

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“…In places with limited availability of on-site ID specialists, the use of structured clinical pathways with support from ASPs can help guide initial patient care activities. 8 This study has several limitations. It was a single-center experience, which decreases the generalizability of these results.…”

Section: Discussionmentioning

confidence: 92%

“…Similar to recent publications, 6 , 7 our study shows that integration of automated alert systems, using the microbiology laboratory and EMR capabilities, can facilitate streamlining the management of SAB, However, interpretation from ID physicians or pharmacists is still needed prior to transmitting recommendations to treating physicians. In places with limited availability of on-site ID specialists, the use of structured clinical pathways with support from ASPs can help guide initial patient care activities 8 …”

Section: Discussionmentioning

confidence: 99%

Antimicrobial Stewardship Program Implementation of a Quality Improvement Intervention Using Real-Time Feedback and an Electronic Order Set for the Management of Staphylococcus aureus Bacteremia

Rosa

Zavala

Cain

et al. 2018

Infect. Control Hosp. Epidemiol.

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Antimicrobial stewardship programs can optimize the management of Staphylococcus aureus bacteremia by integrating information technology and microbiology laboratory resources. This study describes our experience implementing an intervention consisting of real-time feedback and the use of an electronic order set for the management of S. aureus bacteremia. Infect Control Hosp Epidemiol 2018;39:346-349.

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“…Antimicrobial resistance is a global health concern [1] and requires coordinated action at the local, national, and global levels [2]. Uniform and standardized surveillance of antimicrobial use is critical for effective antimicrobial stewardship (AS) not only in tertiary referral hospitals but also in smaller secondary, primary, and specialized hospitals [3].…”

Section: Introductionmentioning

confidence: 99%

Point Prevalence Surveys of Antimicrobial Prescribing in a Non-Acute Care Hospital in Saitama Prefecture, Japan

Ishibashi

Pauwels

Tomori

et al. 2022

Canadian Journal of Infectious Diseases and Medical Microbiolog

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Background. The global point prevalence survey (Global-PPS) is the standard for the surveillance of prescribed antimicrobials among inpatients and provides data for the development of hospital antimicrobial stewardship programs. Aim. To evaluate the prevalence and quality of antimicrobial prescriptions using the universally standardized Global-PPS protocol in a non-acute care hospital in Saitama Prefecture, Japan. Methods. Antimicrobial prescriptions for inpatients, staying at the hospital overnight, were surveyed on three separate week days in November 2018, January 2019, and May 2019. Information on the prescribed antimicrobials on the survey target day was obtained from the in-hospital pharmacy. Survey data were collected by physicians, based on the extracted information. Patient information was anonymized and entered in the Global-PPS Web application by physicians. We report the antimicrobial use prevalence, the indication for prescription, diagnosis, the most prescribed antimicrobials, and a set of quality indicators related to antimicrobial prescribing. Results. In total, 6.7% of the surveyed inpatients (120/1796) were prescribed antimicrobials on the survey day. Sulfamethoxazole/trimethoprim was the most commonly prescribed, with 20.0% of systemic antibiotic prescriptions (ATC J01). Of all antibiotics for systemic use, up to 58.4% were Watch antibiotics, as defined by the World Health Organization AWaRe classification. The most prescribed group of systemic antibiotics was non-penicillin beta-lactam antibiotics (34.4%), followed by penicillin antibiotics in combination with beta-lactamase inhibitors (25.6%), and sulfonamides with trimethoprim (20.8%). Healthcare-associated infections and medical prophylaxis were the most common indications reported in 69.3% and 26.3% of prescriptions, respectively. The most common diagnosis for systemic antibiotic prescriptions was pneumonia (49.6%). Reasons for antimicrobial prescriptions were indicated in the medical records for 67.1% of prescriptions, and the stop/review date was documented to be 50.3%. Compliance with local guidelines reached 66.7%. Conclusions. This study highlights important challenges related to antimicrobial prescription in a highly specific, non-acute care patient population.

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Development and Implementation of an Antimicrobial Stewardship Program in a Rural Hospital

Abstract: -

Cited by 3 publications

References 5 publications

Antimicrobial Usage and Resistance in Makkah Region Hospitals: A Regional Point Prevalence Survey of Public Hospitals

Antimicrobial Usage and Resistance in Makkah Region Hospitals: A Regional Point Prevalence Survey of Public Hospitals

Antimicrobial Stewardship Program Implementation of a Quality Improvement Intervention Using Real-Time Feedback and an Electronic Order Set for the Management of Staphylococcus aureus Bacteremia

Point Prevalence Surveys of Antimicrobial Prescribing in a Non-Acute Care Hospital in Saitama Prefecture, Japan

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