The increasing role of pharmacists in antimicrobial stewardship in English hospitals

Wickens, Hayley; Farrell, Susan E.; Ashiru‐Oredope, Diane; Jacklin, Ann; Holmes, Alison; Cooke, Jonathon; Sharland, Mike; McNulty, C.; Dryden, Matthew; Fry, Carole; Hand, Kieran; Howard, Philip; Johnson, Alan P.; Elson, Richard; Mansell, Paula J.; Faulding, Sue; Wagle, Shama; Smart, Sharon; Wellsteed, Sally

doi:10.1093/jac/dkt241

Cited by 95 publications

(78 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…16 The increasing role of pharmacist-led antimicrobial stewardship activities has also been substantiated by implementation in English hospitals. 17 The creation of such alternative models for stewardship that can be embedded within existing systems is dependent on local context and resources and is key to success across diverse settings. 18 Our study findings support the creation of alternative models to decrease antibiotic overprescribing as a possible approach in South African hospitals.…”

Section: Discussionmentioning

confidence: 99%

Antimicrobial stewardship across 47 South African hospitals: an implementation study

Brink

Messina

Feldman

et al. 2016

The Lancet Infectious Diseases

177

194

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Antimicrobial stewardship across 47 South African hospitals: an implementation study

Brink

Messina

Feldman

et al. 2016

The Lancet Infectious Diseases

177

194

View full text Add to dashboard Cite

“…Widespread and overuse of antibiotics, use of broadspectrum antibiotics when narrow spectrum is available are among the leading causes of ABR (Pulcini et al, 2011;Navarro-San Francisco et al, 2013;Abera et al, 2014;Burger et al, 2016). In ABS, clinicians are encouraged that where it is imperative to start effective broad-spectrum therapy quickly, subsequent daily review of these prescriptions, and de-escalation to narrow-spectrum antibiotics where possible, should be done (Wickens et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

“…In South Africa, Burger et al (2016) recorded 83.1% who knew that ABS is aimed at minimizing toxicity and other adverse effects in patients, among final year pharmacy students. ABS is the practice of escalating and sustaining the rational/judicious use of antibiotics to optimize patient outcomes, reduce costs, and avoid the collateral side effects (such as the generation of resistant organisms and untoward effects in the individual patient) linked with these medications (Struelens, 2003;Wickens et al, 2013;Burger et al, 2016;Erku, 2016).…”

Section: Discussionmentioning

confidence: 99%

Veterinarians’ Perception, Knowledge and Practices of Antibiotic Stewardship in Enugu State Southeast, Nigeria

Anyanwu¹,

Kolade²

2017

Not Sci Biol

View full text Add to dashboard Cite

A cross-sectional survey utilizing structured questionnaires was used to study the veterinarians' perception, knowledge and practices of antibiotic stewardship (ABS) in Enugu State, Southeastern Nigeria. Data obtained were analyzed using chi-square on SPSS (Version 15.0) at a significance level of P < 0.05 to determine possible associations between variables and perceptions/knowledge about ABS. Out of 280 respondents, 41 (17.1%) had heard about ABS. Minority of the respondents perceived/knew that using antibiotics only when necessary (6.4%, 18), administering antibiotics at the appropriate dose (6.4%, 18) and administering antibiotics for appropriate duration in every case (4.3%, 12) were among the principles of ABS. The study also showed that age, gender, qualification, years of practice and locations did not exert any influence (P > 0.05) on the awareness of respondents about ABS. More than one-third of the respondents wrongly perceived that increasing the use of broad-spectrum antibiotics (35.4%, 99) is one of the goals of ABS, whereas the minority of the respondents rightly perceived/knew that minimizing toxicity and other adverse effects (16.8%, 47) and reducing antibiotic resistance (ABR) (43.2%, 121) are also goals of ABS. Only 21.4% (60) had overall knowledge of ABS. Prescribing antibiotics without seeing/examining the patient, prescribing antibiotics for any case suspected to be infectious, prescribing broad-spectrum antibiotics despite availability of narrow-spectrum antibiotics, prescribing different classes/types of antibiotics concurrently to ensure therapeutic efficacy, prescribing overdose of antibiotics to ensure efficacy and non-consultation of the veterinary formulary/other resources when in doubt during prescription, are some of inappropriate/untoward ABS practices/behaviors/attitudes amongst the respondents. No significant association (P > 0.05) was found between practices of ABS and age, gender, qualification, years of practice and location. In conclusion, the veterinarians' awareness/perception and practices of ABS is abysmally poor in the study area, thus education of Nigerian veterinarians about ABS and the teaching of the principles and practices of ABS during veterinary schools are recommended.

show abstract

“…We estimate an approximate response rate of 24% of NHS hospital specialist infection pharmacists and at least 8% of practising UK medical microbiologists. 23,24 Responses were included from 68 unique IP addresses representing up to 36% (68/188) of NHS hospital trusts/boards if the questionnaire was completed from the employing hospital's IP address. [25][26][27][28] Teaching hospitals are proportionately over-represented compared with DGHs but there was a good balance of respondents with experience of EPMA systems and those without.…”

Section: Discussionmentioning

confidence: 99%

Electronic prescribing system design priorities for antimicrobial stewardship: a cross-sectional survey of 142 UK infection specialists

Hand

Cumming

Hopkins

et al. 2016

J. Antimicrob. Chemother.

View full text Add to dashboard Cite

SynopsisThe implementation of electronic prescribing and medication administration systems (EPMAs) is a priority for hospitals and a potential component of antimicrobial stewardship (AMS). ObjectivesThis study aimed to identify software features within EPMAs that could potentially facilitate AMS and to survey practising UK infection specialist healthcare professionals in order to assign priority to these software features. MethodsA questionnaire was developed using nominal group technique and transmitted via email links through professional networks. The questionnaire collected demographic data, information on priority areas and anticipated impact of EPMA. Responses from different respondent groups were compared using the Mann Whitney U test. ResultsResponses were received from 164 individuals (142 analysable). Respondents were predominantly specialist infection pharmacists (48%) or medical microbiologists (37%). 59% of pharmacists had experience of EPMA in their hospitals compared to 35% of microbiologists. Pharmacists assigned higher priority to: indication prompt (p<0.001), allergy checker (p=0.003) treatment protocols (p=0.003), drug-indication mismatch alerts (p=0.031) and prolonged course alerts (p=0.041); and lower priority to a dose checker for adults (p=0.02) and an interaction checker (p<0.05), than microbiologists. A "soft stop" functionality was rated essential or a high priority by 89% of respondents. Potential EPMA software features were expected to have the greatest impact on stewardship, treatment efficacy and patient safety outcomes with lowest impact on Clostridium difficile infection (CDI), antimicrobial resistance and drug expenditure. ConclusionsThe survey demonstrates key differences in health professionals' opinions of different healthcare benefits of EPMA but a consensus of anticipated positive impact on patient safety and antimicrobial stewardship.

show abstract

The increasing role of pharmacists in antimicrobial stewardship in English hospitals

Cited by 95 publications

References 22 publications

Antimicrobial stewardship across 47 South African hospitals: an implementation study

Antimicrobial stewardship across 47 South African hospitals: an implementation study

Veterinarians’ Perception, Knowledge and Practices of Antibiotic Stewardship in Enugu State Southeast, Nigeria

Electronic prescribing system design priorities for antimicrobial stewardship: a cross-sectional survey of 142 UK infection specialists

Contact Info

Product

Resources

About