Identifying Best Practices Across Three Countries: Hospital Antimicrobial Stewardship in the United Kingdom, France, and the United States

Trivedi, Kavita K.; Dumartin, C.; Gilchrist, Mark; Wade, Paul; Howard, Philip

doi:10.1093/cid/ciu538

Cited by 46 publications

(42 citation statements)

References 25 publications

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“…Despite the extensive evidence base, antimicrobial stewardship programmes are not a requirement in all hospitals. [9] Antimicrobial resistance requires global action. The available evidence base suggests that antimicrobial stewardship programmes should be introduced, with su icient trained sta and funding, as widely as possible.…”

mentioning

confidence: 99%

Antimicrobial stewardship: we know it works; time to make sure it is in place everywhere

Plachouras¹,

Hopkins²

2017

Cochrane Database of Systematic Reviews

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The first antimicrobial stewardship programmes were introduced in hospitals more than 30 years ago to address inappropriate antibiotic prescribing and increasing antibiotic resistance.[1][2] Since then a large body of evidence on the e ectiveness and safety of this approach has accumulated, and a new Cochrane Review updates the evidence on interventions and delivery methods to improve antibiotic prescribing.[3] The purpose of antimicrobial stewardship is to promote the prudent use of antibiotics in order to optimize patient outcomes while at the same time minimizing the probability of adverse e ects, including toxicity and the selection of pathogenic organisms, and the emergence and spread of antibiotic resistance.[4] Key evidence-based stewardship interventions (e.g. empirical treatment according to local or national guidelines, de-escalation of treatment, parenteral-to-oral switch, therapeutic drug monitoring, restricted antimicrobial lists) demonstrate benefits in terms of clinical outcome, adverse events, treatment costs, and antibiotic resistance rates.[5] Antimicrobial stewardship: we know it works; time to make sure it is in place everywhere (Editorial) 1

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mentioning

confidence: 99%

Antimicrobial stewardship: we know it works; time to make sure it is in place everywhere

Plachouras¹,

Hopkins²

2017

Cochrane Database of Systematic Reviews

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“…Una de las formas más eficientes para enfrentar la resistencia a antimicrobianos en los microorganismos hospitalarios es la implementación de programas que promuevan su uso racional mediante la implementación de guías de tratamiento para las patologías infecciosas más frecuentes 5,7,10,12,17 . Esto, acompañado del seguimiento al consumo de antimicrobianos en forma controlada, incluyendo restricción de ciertos antimicrobianos de acuerdo a la ecología hospitalaria y sugerencias de cambio en el tratamiento dirigidas por un experto, garantiza un impacto en el consumo, ya que son los factores modificables más importantes en la práctica clínica con respecto al uso de antimicrobianos en una institución.…”

Section: Discussionunclassified

“…En países desarrollados se han realizado estudios que demuestran cómo un programa que promueva el uso racional de antimicrobianos genera un efecto positivo en los costos de la atención en salud, así como también en los patrones de susceptibilidad de los microorganismos aislados 11,12 . En Colombia existe alguna evidencia que los programas de uso racional de antimicrobianos, con la implementación de estrategias de vigilancia y control están asociados a una disminución en el consumo de algunos de ellos, cambio en los patrones de resistencia…”

Section: Introductionunclassified

Impacto del uso racional de antimicrobianos en una clínica de tercer nivel en Colombia

Pallares

Cataño

2017

Rev. chil. infectol.

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“…Various reports [7][8][9] of staffing requirements for AMS programs were reviewed (Table 1). It was determined that due to geographic separation and relatively small daily patient censuses, each facility would not be able to support their own ID pharmacist and physician, as the AMC could.…”

Section: Development Of a Health-system Wide Amsmentioning

confidence: 99%

Implementation of a Health-System Wide Antimicrobial Stewardship Program in Omaha, NE

et al. 2019

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The Centers for Medicare and Medicaid Services (CMS) have mandated that acute care and critical access hospitals implement an Antimicrobial stewardship (AMS) program. This manuscript describes the process that was implemented to ensure CMS compliance for AMS, across a 14-member health system (eight community hospitals, five critical access hospitals, and an academic medical center) in the Omaha metro area, and surrounding cities. The addition of the AMS program to the 14-member health system increased personnel, with a 0.5 full-time equivalent (FTE) infectious diseases (ID) physician, and 2.5 FTE infectious diseases trained clinical pharmacists to support daily AMS activities. Clinical decision support software had previously been implemented across the health system, which was also key to the success of the program. Overall, in its first year, the AMS program demonstrated a $1.2 million normalized reduction (21% total reduction in antimicrobial purchases) in antimicrobial expenses. The ability to review charts daily for antimicrobial optimization with ID pharmacist and physician support, identify facility specific needs and opportunities, and to collect available data endpoints to determine program effectiveness helped to ensure the success of the program.

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Identifying Best Practices Across Three Countries: Hospital Antimicrobial Stewardship in the United Kingdom, France, and the United States

Cited by 46 publications

References 25 publications

Antimicrobial stewardship: we know it works; time to make sure it is in place everywhere

Antimicrobial stewardship: we know it works; time to make sure it is in place everywhere

Impacto del uso racional de antimicrobianos en una clínica de tercer nivel en Colombia

Implementation of a Health-System Wide Antimicrobial Stewardship Program in Omaha, NE

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