Economic Evaluations on Antimicrobial Stewardship Programme: A Systematic Review

Ibrahim, Nor Haizan; Maruan, Khalidah; Khairy, Hasryn Azzuar Mohd; Hong, Yet Hoi; Dali, Ahmad Fauzi; Neoh, Chin Fen

doi:10.18433/j3nw7g

Cited by 35 publications

(15 citation statements)

References 16 publications

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“…To curb this overarching problem, antimicrobial stewardship (AMS) programmes, which aim to improve judicious and effective use of antimicrobial agents, have been introduced and implemented in many parts of the world. Previous studies have revealed that AMS programmes improved awareness of healthcare providers towards appropriate antimicrobial use and therefore reducing antimicrobial resistance with better clinical and economic outcomes 4–6. In Malaysia, initiatives have been taken by the Ministry of Health (MOH) through the establishment of a protocol on AMS for all healthcare facilities in 2014 7.…”

Section: Introductionmentioning

confidence: 99%

Perception and practices of public hospital pharmacists towards the antimicrobial stewardship programme in the State of Selangor, Malaysia

et al. 2018

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ObjectiveThe increase in antimicrobial resistance and the lack of new antimicrobial agents in drug discovery pipelines have called for global attention to mitigate the problem of antimicrobial misuse. While an antimicrobial stewardship (AMS) programme has been implemented in Malaysia, the perception and practices of public hospital pharmacists remain unknown. The aim of this study was to determine the perception and practices of Malaysian public hospital pharmacists towards the AMS programme in the state of Selangor, Malaysia.MethodsA cross-sectional study, using a validated 23-item self-administered questionnaire, was conducted among pharmacists from 11 public hospitals in the State of Selangor, Malaysia, from December 2016 to January 2017. All public hospital pharmacists (n=432) were invited to participate in the survey. A 5-point Likert scale was employed in the questionnaire; the perception section was scored from 1 (strongly disagree) to 5 (strongly agree) while the practice section was scored from 1 (never) to 5 (always). Both descriptive and inferential statistical analyses were used to analyse data.ResultsOf the 432 pharmacists surveyed, 199 responded, giving a response rate of 46.0%. The majority of the respondents agreed (n=190, 95.5%) that the AMS programme improves patient care at their hospitals (median=5; IQR=1). Slightly less than half of the respondents indicated that a local antibiotic guideline was established in their hospitals (median=3, IQR=2.5), and had taken part in antimicrobial awareness campaigns to promote optimal use of antimicrobials in hospitals (median=3, IQR=1).ConclusionsOverall, the perception and practices of the surveyed hospital pharmacists towards AMS programme were positive. National antibiotic guidelines, which take into consideration local antimicrobial resistance patterns, should be used fully to improve antimicrobial usage and to reduce practice variation. Collaboration among healthcare professionals should be strengthened to minimise the unfavourable consequences of unintended use of antimicrobial agents while optimising clinical outcomes.

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Section: Introductionmentioning

confidence: 99%

Perception and practices of public hospital pharmacists towards the antimicrobial stewardship programme in the State of Selangor, Malaysia

et al. 2018

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“…Regarding the outcome elements, in countries that lack data and resources, the value of ASPs is not always reported with metrics that allow for program assessment ( 33 ). Recently published reviews ( 34 – 36 ) showed that cost-effectiveness studies are most common in the United States and European countries. In fact, a recent review ( 34 ) showed that only one study of cost-effectiveness had been developed in LMICs.…”

Section: Discussionmentioning

confidence: 99%

Antimicrobial stewardship in hospitals in Latin America and the Caribbean: a scoping review

Hegewisch-Taylor

Dreser

Romero-Mónico

et al. 2020

Revista Panamericana De Salud Pública

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Objectives. To examine published antimicrobial stewardship (AMS) initiatives in hospitals in Latin America and the Caribbean (LAC) in order to characterize AMS terminology usage, geotemporality, and elements of structure (human resources), process (interventions), and outcomes, and to set priority areas for improving AMS reporting. Methods. This was a scoping review that searched PubMed, LILACS, EMBASE, and 12 other databases, along with a manual search for academic and grey literature to identify documents on AMS initiatives in hospitals in 33 countries of LAC, up to August 2019. Keywords included ‘antibiotic’ or ‘antimicrobial’ AND ‘stewardship, policy, strategies, management, control, rational use, appropriate use, surveillance, or interventions’ and 33 country names. Results. Selected articles totalled 147 studies published in 1985 – 2019; of those, 22% used ‘antimicrobial stewardship’ in the title. Eighteen countries published AMS hospital initiatives, one-half of which were implemented in capital cities. Brazil, Argentina, Colombia, Cuba, Mexico, and Chile, in descending frequency, made up > 59% of published initiatives. Educational interventions were the most frequently reported, followed by persuasive and restrictive strategies. Antimicrobial consumption was the most common outcome measure reported. About one-third of the studies (35%) referred to baseline measures-only in preparation for AMS interventions. Fifty-nine studies from 6 countries reported AMS comprehensively, using structure, process, and outcome (SPO) elements. Conclusions. Published hospital AMS initiatives have increased over time and have expanded across LAC. However, more programs need to be developed. Complete reporting of SPO elements is imperative to evaluating and replicating AMS actions.

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“…Furthermore, the use of prophylactic antibiotics is discouraged because they may lead to the selection of resistant flora (16). Antibiotic stewardship programs (ASP), which include prospective audits with intervention and feedback, and formulary restriction and pre-authorization, have been proven to be effective in reducing the unnecessary use of antibiotics (17). One measure is the rational use of antibiotics which can be replaced by antiseptics.…”

Section: Discussionmentioning

confidence: 99%

Tolerability and Safety of Urotainer® Polihexanide 0.02% in Long-Term Catheterized Patients: A Prospective Cohort Study

Pannek

Everaert

Möhr

et al. 2020

Preprint

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Background: In patients with long-term indwelling bladder catheters, bacterial colonization is inevitable, leading to urinary tract infections or encrustations with subsequent catheter blockage. Currently, bladder irrigations are the most frequently used prophylactic means, but the best solution remains yet to be determined. In vitro studies demonstrate that polihexanide is a promising option for catheter irrigation, but no data about safety and tolerability exist.Methods: In a prospective observational study in patients with long-term (> 2 weeks) indwelling bladder catheter, a 0.02% polihexanide solution was used to rinse the catheter on five consecutive days. Adverse events, tolerability and vital signs were assessed before, during, after and at the end of the treatment period. Results: There was no serious adverse event in the study. A total of 28 adverse events (AEs) in 15 (46.88%) participants were experienced. Absolute changes in pain scores were not clinically relevant. No incidences of either flushing or sweating were found during instillation. Bladder spasms during instillation were reported in two cases during a single instillation. Mean pulse rates did not change by more than 3 beats per minute. Mean changes in body temperature did not exceed 0.12 °C. Clinically relevant changes in blood pressure were recorded for 3 patients.Conclusions: This is the first study to demonstrate that a 0.02% polihexanide solution can safely be used for catheter irrigation.

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Economic Evaluations on Antimicrobial Stewardship Programme: A Systematic Review

Cited by 35 publications

References 16 publications

Perception and practices of public hospital pharmacists towards the antimicrobial stewardship programme in the State of Selangor, Malaysia

Perception and practices of public hospital pharmacists towards the antimicrobial stewardship programme in the State of Selangor, Malaysia

Antimicrobial stewardship in hospitals in Latin America and the Caribbean: a scoping review

Tolerability and Safety of Urotainer® Polihexanide 0.02% in Long-Term Catheterized Patients: A Prospective Cohort Study

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