Abstract
Abstract
Background
The Global Point Prevalence Survey of Antimicrobial Consumption and Resistance (Global-PPS) provides a methodology to support hospitals worldwide in collecting antimicrobial use data. We aim to evaluate the impact of the Global-PPS on local antimicrobial stewardship (AMS) programmes and assess health care professionals’ educational needs and barriers for implementing AMS.
Methods
A cross-sectional survey was disseminated within the Global-PPS network. The target audience consisted of hospital healthcare workers, involved in local surveillance of antimicrobial consumption and resistance. This included contacts from hospitals that already participated in the Global-PPS or were planning to do so. The survey contained 24 questions that addressed the hospital’s AMS activities, experiences conducting the PPS, as well as the learning needs and barriers for implementing AMS.
Results
A total of 248 hospitals from 74 countries participated in the survey, of which 192 had already conducted the PPS at least once. The survey response rate was estimated at 25%. In 96.9% of these 192 hospitals, Global-PPS participation had led to the identification of problems related to antimicrobial prescribing. In 69.3% at least one of the hospital’s AMS components was initiated as a result of Global-PPS findings. The level of AMS implementation varied across regions. Up to 43.1% of all hospitals had a formal antimicrobial stewardship strategy, ranging from 10.8% in Africa to 60.9% in Northern America. Learning needs of hospitals in high-income countries and in low-and middle-income countries were largely similar and included general topics (e.g. ‘optimising antibiotic treatment’), but also PPS-related topics (e.g. ‘translating PPS results into meaningful interventions’). The main barriers to implementing AMS programmes were a lack of time (52.7%), knowledge on good prescribing practices (42.0%), and dedicated funding (39.9%). Hospitals in LMIC more often reported unavailability of prescribing guidelines, insufficient laboratory capacity and suboptimal use of the available laboratory services.
Conclusions
Although we observed substantial variation in the level of AMS implementation across regions, the Global-PPS has been very useful in informing stewardship activities in many participating hospitals. More is still to be gained in guiding hospitals to integrate the PPS throughout AMS activities, building on existing structures and processes.
Publisher
Springer Science and Business Media LLC
Subject
Pharmacology (medical),Infectious Diseases,Microbiology (medical),Public Health, Environmental and Occupational Health
Reference54 articles.
1. World Health Organization. Global Action Plan on Antimicrobial Resistance. 2015. https://www.who.int/antimicrobial-resistance/publications/global-action-plan/en/. Accessed 2 Sep 2020.
2. Laxminarayan R, Duse A, Wattal C, Zaidi AKM, Wertheim HFL, Sumpradit N, et al. Antibiotic resistance-the need for global solutions. Lancet Infect Dis. 2013;13(12):1057–98.
3. Dyar OJ, Huttner B, Schouten J, Pulcini C. What is antimicrobial stewardship? Clin Microbiol Infect. 2017;23(11):793–8.
4. Schuts EC, Hulscher MEJL, Mouton JW, Verduin CM, Stuart JWTC, Overdiek HWPM, et al. Current evidence on hospital antimicrobial stewardship objectives: a systematic review and meta-analysis. Lancet Infect Dis. 2016;16(7):847–56.
5. Davey P, Marwick CA, Scott CL, Charani E, Mcneil K, Brown E, et al. Interventions to improve antibiotic prescribing practices for hospital inpatients. Cochrane Database Syst Rev. 2017;2(2):CD003543.
Cited by
18 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献