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Feasibility Study of the World Health Organization Health Care Facility-Based Antimicrobial Stewardship Toolkit for Low- and Middle-Income Countries

Antimicrobial stewardship (AMS) has emerged as a systematic approach to optimize antimicrobial use and reduce antimicrobial resistance. To support the implementation of AMS programs, the World Health Organization developed a draft toolkit for health care facility AMS programs in low- and middle-inco...

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Autores principales: Maki, Gina, Smith, Ingrid, Paulin, Sarah, Kaljee, Linda, Kasambara, Watipaso, Mlotha, Jessie, Chuki, Pem, Rupali, Priscilla, Singh, Dipendra R., Bajracharya, Deepak C., Barrow, Lisa, Johnson, Eliaser, Prentiss, Tyler, Zervos, Marcus
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7558985/
https://www.ncbi.nlm.nih.gov/pubmed/32872440
http://dx.doi.org/10.3390/antibiotics9090556
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author Maki, Gina
Smith, Ingrid
Paulin, Sarah
Kaljee, Linda
Kasambara, Watipaso
Mlotha, Jessie
Chuki, Pem
Rupali, Priscilla
Singh, Dipendra R.
Bajracharya, Deepak C.
Barrow, Lisa
Johnson, Eliaser
Prentiss, Tyler
Zervos, Marcus
author_facet Maki, Gina
Smith, Ingrid
Paulin, Sarah
Kaljee, Linda
Kasambara, Watipaso
Mlotha, Jessie
Chuki, Pem
Rupali, Priscilla
Singh, Dipendra R.
Bajracharya, Deepak C.
Barrow, Lisa
Johnson, Eliaser
Prentiss, Tyler
Zervos, Marcus
author_sort Maki, Gina
collection PubMed
description Antimicrobial stewardship (AMS) has emerged as a systematic approach to optimize antimicrobial use and reduce antimicrobial resistance. To support the implementation of AMS programs, the World Health Organization developed a draft toolkit for health care facility AMS programs in low- and middle-income countries. A feasibility study was conducted in Bhutan, the Federated States of Micronesia, Malawi, and Nepal to obtain local input on toolkit content and implementation of AMS programs. This descriptive qualitative study included semi-structured interviews with national- and facility-level stakeholders. Respondents identified AMS as a priority and perceived the draft toolkit as a much-needed document to further AMS program implementation. Facilitators for implementing AMS included strong national and facility leadership and clinical staff engagement. Barriers included lack of human and financial resources, inadequate regulations for prescription antibiotic sales, and insufficient AMS training. Action items for AMS implementation included improved laboratory surveillance, establishment of a stepwise approach for implementation, and mechanisms for reporting and feedback. Recommendations to improve the AMS toolkit’s content included additional guidance on defining the responsibilities of the committees and how to prioritize AMS programming based on local context. The AMS toolkit was perceived to be an important asset as countries and health care facilities move forward to implement AMS programs.
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spelling pubmed-75589852020-10-26 Feasibility Study of the World Health Organization Health Care Facility-Based Antimicrobial Stewardship Toolkit for Low- and Middle-Income Countries Maki, Gina Smith, Ingrid Paulin, Sarah Kaljee, Linda Kasambara, Watipaso Mlotha, Jessie Chuki, Pem Rupali, Priscilla Singh, Dipendra R. Bajracharya, Deepak C. Barrow, Lisa Johnson, Eliaser Prentiss, Tyler Zervos, Marcus Antibiotics (Basel) Article Antimicrobial stewardship (AMS) has emerged as a systematic approach to optimize antimicrobial use and reduce antimicrobial resistance. To support the implementation of AMS programs, the World Health Organization developed a draft toolkit for health care facility AMS programs in low- and middle-income countries. A feasibility study was conducted in Bhutan, the Federated States of Micronesia, Malawi, and Nepal to obtain local input on toolkit content and implementation of AMS programs. This descriptive qualitative study included semi-structured interviews with national- and facility-level stakeholders. Respondents identified AMS as a priority and perceived the draft toolkit as a much-needed document to further AMS program implementation. Facilitators for implementing AMS included strong national and facility leadership and clinical staff engagement. Barriers included lack of human and financial resources, inadequate regulations for prescription antibiotic sales, and insufficient AMS training. Action items for AMS implementation included improved laboratory surveillance, establishment of a stepwise approach for implementation, and mechanisms for reporting and feedback. Recommendations to improve the AMS toolkit’s content included additional guidance on defining the responsibilities of the committees and how to prioritize AMS programming based on local context. The AMS toolkit was perceived to be an important asset as countries and health care facilities move forward to implement AMS programs. MDPI 2020-08-29 /pmc/articles/PMC7558985/ /pubmed/32872440 http://dx.doi.org/10.3390/antibiotics9090556 Text en © 2020 World Health Organization; Licensee MDPI, Basel, Switzerland. This is an open access article distributed under the terms of the Creative Commons Attribution IGO License (CC BY) license (http://creativecommons.org/licenses/by/3.0/igo/legalcode), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. In any reproduction of this article there should not be any suggestion that WHO or this article endorse any specific organisation or products. The use of the WHO logo is not permitted.
spellingShingle Article
Maki, Gina
Smith, Ingrid
Paulin, Sarah
Kaljee, Linda
Kasambara, Watipaso
Mlotha, Jessie
Chuki, Pem
Rupali, Priscilla
Singh, Dipendra R.
Bajracharya, Deepak C.
Barrow, Lisa
Johnson, Eliaser
Prentiss, Tyler
Zervos, Marcus
Feasibility Study of the World Health Organization Health Care Facility-Based Antimicrobial Stewardship Toolkit for Low- and Middle-Income Countries
title Feasibility Study of the World Health Organization Health Care Facility-Based Antimicrobial Stewardship Toolkit for Low- and Middle-Income Countries
title_full Feasibility Study of the World Health Organization Health Care Facility-Based Antimicrobial Stewardship Toolkit for Low- and Middle-Income Countries
title_fullStr Feasibility Study of the World Health Organization Health Care Facility-Based Antimicrobial Stewardship Toolkit for Low- and Middle-Income Countries
title_full_unstemmed Feasibility Study of the World Health Organization Health Care Facility-Based Antimicrobial Stewardship Toolkit for Low- and Middle-Income Countries
title_short Feasibility Study of the World Health Organization Health Care Facility-Based Antimicrobial Stewardship Toolkit for Low- and Middle-Income Countries
title_sort feasibility study of the world health organization health care facility-based antimicrobial stewardship toolkit for low- and middle-income countries
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7558985/
https://www.ncbi.nlm.nih.gov/pubmed/32872440
http://dx.doi.org/10.3390/antibiotics9090556
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