Antibiotic usage in south-western French hospitals: trends and association with antibiotic stewardship measures

Dumartin, C.; Rogues, Anne-Marie; Amadéo, Brice; Péfau, Muriel; Venier, Anne-Gaëlle; Parneix, Pierre; Maurain, Catherine

doi:10.1093/jac/dkr179

Cited by 24 publications

(15 citation statements)

References 25 publications

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“…The situation in the UK contrasts with recent data from the United States, with just over half of hospitals ( n = 206 of 406 responding hospitals) reporting the existence of an AMT . Similarly, just over half of hospitals reported an AMT in south‐western French hospitals (56% of 74 responding hospitals) . In our study, the presence of an AMT was significantly associated with presence of infectious disease, microbiology and emergency departments.…”

Section: Discussioncontrasting

confidence: 99%

“…16 Similarly, just over half of hospitals reported an AMT in south-western French hospitals (56% of 74 responding hospitals). 17 In our study, the presence of an AMT was significantly associated with presence of infectious disease, microbiology and emergency departments. Furthermore, hospitals in England and those with higher bed capacity were also more likely to have an AMT.…”

Section: Discussionsupporting

confidence: 47%

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A cross-sectional survey of antimicrobial stewardship strategies in UK hospitals

2014

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionsupporting

confidence: 47%

A cross-sectional survey of antimicrobial stewardship strategies in UK hospitals

2014

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“…37 Eighty-five perecent of these hospitals had antibiotic advisors. On the other hand, Dumartin's group [37][38][39] reported that pharmacist time dedicated to antibiotic management, restrictive dispensation using stop-orders, computerized tools, continuing education, and audits were components that remained underused. Components identified as playing a role in AS were similar to those reported in the HAIG survey and the extent to which these structure and processes have been implemented within the VA was comparable with that in other studies.…”

Section: Discussionmentioning

confidence: 99%

“…Components identified as playing a role in AS were similar to those reported in the HAIG survey and the extent to which these structure and processes have been implemented within the VA was comparable with that in other studies. [37][38][39] However, each of these studies addressed only a few components and none is as comprehensive as the HAIG survey in examining ASP components.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of Antimicrobial Stewardship Programs at Veterans Affairs Hospitals: Results of a Nationwide Survey

Chou

Graber

Jones

et al. 2016

Infect. Control Hosp. Epidemiol.

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BACKGROUNDAntimicrobial stewardship programs (ASPs) are variably implemented.OBJECTIVETo characterize variations of antimicrobial stewardship structure and practices across all inpatient Veterans Affairs facilities in 2012 and correlate key characteristics with antimicrobial usage.DESIGNA web-based survey regarding stewardship activities was administered to each facility’s designated contact. Bivariate associations between facility characteristics and inpatient antimicrobial use during 2012 were determined.SETTINGTotal of 130 Veterans Affairs facilities with inpatient services.RESULTSOf 130 responding facilities, 29 (22%) had a formal policy establishing an ASP, and 12 (9%) had an approved ASP business plan. Antimicrobial stewardship teams were present in 49 facilities (38%); 34 teams included a clinical pharmacist with formal infectious diseases (ID) training. Stewardship activities varied across facilities, including development of yearly antibiograms (122 [94%]), formulary restrictions (120 [92%]), stop orders for antimicrobial duration (98 [75%]), and written clinical pathways for specific conditions (96 [74%]). Decreased antimicrobial usage was associated with having at least 1 full-time ID physician (P=.03), an ID fellowship program (P=.003), and a clinical pharmacist with formal ID training (P=.006) as well as frequency of systematic patient-level reviews of antimicrobial use (P=.01) and having a policy to address antimicrobial use in the context of Clostridium difficile infection (P=.01). Stop orders for antimicrobial duration were associated with increased use (P=.03).CONCLUSIONSASP-related activities varied considerably. Decreased antibiotic use appeared related to ID presence and certain select practices. Further statistical assessments may help optimize antimicrobial practices.Infect Control Hosp Epidemiol 2016;37:647–654

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“…142,143 Guidelines for treatment of infections should be reviewed to ensure that alternatives to broad-spectrum agents are provided and that de-escalation of antibiotics and reductions in use of specific antimicrobial classes and total antibiotic burden are emphasized. 139,144 Antimicrobials such as carbapenems, fluoroquinolones, and metronidazole have been identified as possible risk factors for acquisition of CRE. 3,6,92,101 In the setting of CRE transmission, whether sporadic or epidemic, it is important to ensure minimization of unnecessary and unnecessarily broad-spectrum antibiotic use.…”

Section: Local and National Antimicrobial Stewardship (Ams) Programsmentioning

confidence: 99%

Carbapenem-ResistantEnterobacteriaceae: A Strategic Roadmap for Infection Control

Friedman

Carmeli

Walton

et al. 2017

Infect. Control Hosp. Epidemiol.

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The incidence of carbapenem-resistant Enterobacteriaceae (CRE) has increased worldwide with great regional variability. Infections caused by these organisms are associated with crude mortality rates of up to 70%. The spread of CRE in healthcare settings is both an important medical problem and a major global public health threat. All countries are at risk of falling victim to the emergence of CRE; therefore, a preparedness plan is required to avoid the catastrophic natural course of this epidemic. Proactive and adequate preventive measures locally, regionally, and nationally are required to contain the spread of these bacteria. The keys to success in preventing the establishment of CRE endemicity in a region are early detection through targeted laboratory protocols and containment of spread through comprehensive infection control measures. This guideline provides a strategic roadmap for infection control measures based on the best available evidence and expert opinion, to enable preparation of a multifaceted preparedness plan to abort epidemics of CRE. Infect Control Hosp Epidemiol 2017;38:580-594.

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Antibiotic usage in south-western French hospitals: trends and association with antibiotic stewardship measures

Abstract: This first longitudinal study, in 74 hospitals, showed that human resources and persuasive ABS measures, in the context of a multidisciplinary approach, are helpful in controlling total antibiotic and fluoroquinolone use.

Cited by 24 publications

References 25 publications

A cross-sectional survey of antimicrobial stewardship strategies in UK hospitals

A cross-sectional survey of antimicrobial stewardship strategies in UK hospitals

Characteristics of Antimicrobial Stewardship Programs at Veterans Affairs Hospitals: Results of a Nationwide Survey

Carbapenem-ResistantEnterobacteriaceae: A Strategic Roadmap for Infection Control

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