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Implementation of antibiotic stewardship in different settings - results of an international survey

BACKGROUND: Antibiotic stewardship interventions are being implemented across different healthcare settings. We report the findings of a global survey of healthcare professionals on the implementation of antibiotic stewardship programmes. METHODS: Learners of a Massive Online Open Course (MOOC) on a...

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Autores principales: Charani, E., Castro-Sanchéz, Enrique, Bradley, S., Nathwani, D., Holmes, Alison H., Davey, P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6373024/
https://www.ncbi.nlm.nih.gov/pubmed/30805181
http://dx.doi.org/10.1186/s13756-019-0493-7
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author Charani, E.
Castro-Sanchéz, Enrique
Bradley, S.
Nathwani, D.
Holmes, Alison H.
Davey, P.
author_facet Charani, E.
Castro-Sanchéz, Enrique
Bradley, S.
Nathwani, D.
Holmes, Alison H.
Davey, P.
author_sort Charani, E.
collection PubMed
description BACKGROUND: Antibiotic stewardship interventions are being implemented across different healthcare settings. We report the findings of a global survey of healthcare professionals on the implementation of antibiotic stewardship programmes. METHODS: Learners of a Massive Online Open Course (MOOC) on antibiotic stewardship were invited to complete an online survey on the core available organisational resources for stewardship. The categorical variables were analysed using chi-squared test, and Likert questions were analysed using an ordinal regression model. The p-values were considered as two-tailed. Significance was set at p-value of < 0.05. RESULTS: The response rate was 55% (505/920), from 53 countries. The responders were 36% (182) doctors, 26% (130) pharmacists, 18% (89) nurses and 20% (104) other (researchers, students and members of the public). Post-graduate training in infection management and stewardship was reported by 56% of doctors compared with 43% (OR 0.59, 95%CI 0.35–1.00) nurses and 35% (OR 0.39, 95%CI 0.24–0.62) of pharmacists. Hospitals were significantly (83% in teaching hospitals, 79% in regional hospitals, p = < 0.01) more likely to have antibiotic policies, when compared to primary care. A surveillance mechanism for antibiotic consumption was reported in 58% (104/178) of teaching hospitals and 62% (98/159) of regional hospitals. Antimicrobial resistance, patient needs, policy, peer influence and specialty level culture and practices were deemed important determinants for decision-making. CONCLUSION: Postgraduate training and support in antibiotic prescribing remains low amongst nurses and pharmacists. Whilst antibiotic policies and committees are established in most institutions, surveillance of antibiotic use is not. The impact of specialty level culture, and peer influence appears to be important factors of antibiotic prescribing.
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spelling pubmed-63730242019-02-25 Implementation of antibiotic stewardship in different settings - results of an international survey Charani, E. Castro-Sanchéz, Enrique Bradley, S. Nathwani, D. Holmes, Alison H. Davey, P. Antimicrob Resist Infect Control Research BACKGROUND: Antibiotic stewardship interventions are being implemented across different healthcare settings. We report the findings of a global survey of healthcare professionals on the implementation of antibiotic stewardship programmes. METHODS: Learners of a Massive Online Open Course (MOOC) on antibiotic stewardship were invited to complete an online survey on the core available organisational resources for stewardship. The categorical variables were analysed using chi-squared test, and Likert questions were analysed using an ordinal regression model. The p-values were considered as two-tailed. Significance was set at p-value of < 0.05. RESULTS: The response rate was 55% (505/920), from 53 countries. The responders were 36% (182) doctors, 26% (130) pharmacists, 18% (89) nurses and 20% (104) other (researchers, students and members of the public). Post-graduate training in infection management and stewardship was reported by 56% of doctors compared with 43% (OR 0.59, 95%CI 0.35–1.00) nurses and 35% (OR 0.39, 95%CI 0.24–0.62) of pharmacists. Hospitals were significantly (83% in teaching hospitals, 79% in regional hospitals, p = < 0.01) more likely to have antibiotic policies, when compared to primary care. A surveillance mechanism for antibiotic consumption was reported in 58% (104/178) of teaching hospitals and 62% (98/159) of regional hospitals. Antimicrobial resistance, patient needs, policy, peer influence and specialty level culture and practices were deemed important determinants for decision-making. CONCLUSION: Postgraduate training and support in antibiotic prescribing remains low amongst nurses and pharmacists. Whilst antibiotic policies and committees are established in most institutions, surveillance of antibiotic use is not. The impact of specialty level culture, and peer influence appears to be important factors of antibiotic prescribing. BioMed Central 2019-02-12 /pmc/articles/PMC6373024/ /pubmed/30805181 http://dx.doi.org/10.1186/s13756-019-0493-7 Text en © The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Charani, E.
Castro-Sanchéz, Enrique
Bradley, S.
Nathwani, D.
Holmes, Alison H.
Davey, P.
Implementation of antibiotic stewardship in different settings - results of an international survey
title Implementation of antibiotic stewardship in different settings - results of an international survey
title_full Implementation of antibiotic stewardship in different settings - results of an international survey
title_fullStr Implementation of antibiotic stewardship in different settings - results of an international survey
title_full_unstemmed Implementation of antibiotic stewardship in different settings - results of an international survey
title_short Implementation of antibiotic stewardship in different settings - results of an international survey
title_sort implementation of antibiotic stewardship in different settings - results of an international survey
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6373024/
https://www.ncbi.nlm.nih.gov/pubmed/30805181
http://dx.doi.org/10.1186/s13756-019-0493-7
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