Assessing the impact of the Global Point Prevalence Survey of Antimicrobial Consumption and Resistance (Global-PPS) on hospital antimicrobial stewardship programmes: results of a worldwide survey

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.

Gaps and barriers in the implementation and functioning of antimicrobial stewardship programmes: results from an educational and behavioural mixed methods needs assessment in France, the United States, Mexico and India

“… 3 A recent study found that local, evidence-based AMS guidelines were used in 96% of North American hospitals, compared with 77% in Latin America, 72% in Europe and 76% in Asia. 8 AMS facilitators’ efforts were in-person training for a range of HCPs, locally relevant evidence-based guidelines and the establishment of a multidisciplinary team who monitor and manage AMS. 8 Given education is a known facilitator to implementation, it is essential to gain a better understanding of the educational needs and current practice gaps that might hinder the implementation of strategies aimed to enhance adherence to AMS principles.…”

“… 8 AMS facilitators’ efforts were in-person training for a range of HCPs, locally relevant evidence-based guidelines and the establishment of a multidisciplinary team who monitor and manage AMS. 8 Given education is a known facilitator to implementation, it is essential to gain a better understanding of the educational needs and current practice gaps that might hinder the implementation of strategies aimed to enhance adherence to AMS principles. 9 To identify the educational needs of HCPs in AMS, this study assessed the current knowledge, skills and beliefs of HCPs, in addition to systemic barriers that obstruct adherence to AMS principles, which is the focus of this paper.…”

Antimicrobial Prescribing Patterns in Patients with COVID-19 in Russian Multi-Field Hospitals in 2021: Results of the Global-PPS Project

“…The study was carried out in the second half of 2021 as a part of the international Global-PPS Project [ 13 ] using the conventional point prevalence study methodology [ 16 ]. PPS is a universal tool that allows information to be obtained on the use of AMD in hospitalized patients to reveal the main problems and develop targeted measures as a part of local AMS programs and to monitor the effectiveness of their implementation [ 12 , 17 ]. The results of the study will provide a basis for the development of appropriate stewardship activities, tailored according to local practices for each multi-field hospital in the project in the COVID-19 pandemic period and thereafter.…”

“…Still, information on antimicrobial consumption and prescribing in inpatients with COVID-19 in Russian hospitals remains sparse and understudied. Point prevalence studies (PPS) have established themselves as a convenient, low-cost, and at the same time standardized and validated tool for monitoring the prescribing of drugs in inpatients to aid antimicrobial stewardship (AMS) activities [ 12 ].…”

Auditing tools for antimicrobial prescribing in solid organ transplant recipients: The why, the how, and an assessment of current options

“…44 There are three survey periods for data collection within the calendar year and at the end of 2018, and Global-PPS has been used in over 700 hospitals in more than 70 countries worldwide. 43 The Global-PPS auditing tool collects detailed data on patient demographics, antimicrobial regimen, indication by diagnostic codes, and intention (prophylaxis, empirical, or targeted therapy). Similar to the NHSN AU and AR module, microorganisms by resistance type is categorized and reported.…”