Legal framework of antimicrobial stewardship in hospitals (LEASH): a European Society of Clinical Microbiology and Infectious Diseases (ESCMID) cross-sectional international survey

Beović, Bojana; Pulcini, Céline; Dumartin, C.; Béraud, Guillaume; Nerat, Barbara; Maurel, Cristina; Doušak, May; Čižman, Milan; Allerberger, Franz; Benkő, Ria; Berild, Dag; Cunney, Robert; Debacker, M; Deptuła, Aleksander; Dumpis, Uga; Dyar, Oliver James; Ergönül, Önder; Szabó, Bálint Gergely; Gormley, Cairine; Grape, Malin; Guðnason, Þórólfur; Howard, Philip; Huttner, Benedikt; Ιωάννου, Πέτρος; Ionescu, Ramona; Keuleyan, Emma; Knepper, Viviane; Kofteridis, Diamantis P.; Kostyanev, Tomislav; Krčméry, V.; Lakatos, Botond; Luzzati, Roberto; Oever, Jaap ten; Pagani, Léonardo; Pardo, José Ramón Paño; Popescu, Mihaela; Popovici, Mihaela; Paul, Mical; Bix, Hege Salvesen; Schouten, Jeroen; Sneddon, Jacqueline; Stevanović, Goran; Wechsler-Fördös, Agnes; With, Katja de; Vlahović‐Palčevski, Vera; Zarb, Peter

doi:10.1016/j.ijantimicag.2018.07.019

Cited by 9 publications

(4 citation statements)

References 14 publications

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“…1, eTable 6). These numbers are in line with a recently published survey [15], and different from IPC, where guidance and national requirements existed in nearly two-thirds of countries [16].…”

Section: Ams and Ipc Activities In Hospitalssupporting

confidence: 82%

Organization and training at national level of antimicrobial stewardship and infection control activities in Europe: an ESCMID cross-sectional survey

Maraolo

Ong²,

Cimen³

et al. 2019

Eur J Clin Microbiol Infect Dis

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Antimicrobial stewardship (AMS) and Infection prevention and control (IPC) are two key complementary strategies that combat development and spread of antimicrobial resistance. The ESGAP (ESCMID Study Group for AMS), EUCIC (European Committee on Infection Control) and TAE (Trainee Association of ESCMID) investigated how AMS and IPC activities and training are organized, if present, at national level in Europe. From February 2018 to May 2018, an internet-based cross-sectional survey was conducted through a 36-item questionnaire, involving up to three selected respondents per country, from 38 European countries in total (including Israel), belonging to the ESGAP/EUCIC/TAE networks. All 38 countries participated with at least one respondent, and a total of 81 respondents. Education and involvement in AMS programmes were mandatory during the postgraduate training of clinical microbiology and infectious diseases specialists in up to one-third of countries. IPC was acknowledged as a specialty in 32% of countries. Only 32% of countries had both guidance and national requirements regarding AMS programmes, in contrast to 61% for IPC. Formal national staffing standards for AMS and IPC hospital-based activities were present in 24% and 63% of countries, respectively. The backgrounds of professionals responsible for AMS and IPC programmes varied tremendously between countries. The organization and training of AMS and IPC in Europe are heterogeneous and national requirements for activities are frequently lacking.

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Section: Ams and Ipc Activities In Hospitalssupporting

confidence: 82%

Organization and training at national level of antimicrobial stewardship and infection control activities in Europe: an ESCMID cross-sectional survey

Maraolo

Ong²,

Cimen³

et al. 2019

Eur J Clin Microbiol Infect Dis

Self Cite

View full text Add to dashboard Cite

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“…Be familiar with national/regional regulation and requirements Regional or national regulatory stewardship frameworks may already exist in your country [9,11]. Understanding these will strengthen your hand in motivating your hospital administrator to adopt core elements/items mentioned above.…”

Section: Be Familiar With Existing Ams Core Elementsmentioning

confidence: 99%

How to start an antimicrobial stewardship programme in a hospital

Mendelson

Morris

Thursky

et al. 2020

Clinical Microbiology and Infection

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Background: Antimicrobial stewardship (AMS) describes a coherent set of actions that ensure optimal use of antimicrobials to improve patient outcomes, while limiting the risk of adverse events (including antimicrobial resistance (AMR)). Introduction of AMS programmes in hospitals is part of most national action plans to mitigate AMR, yet the optimal components and actions of such a programme remain undetermined. Objectives: To describe how health-care professionals can start an AMS programme in their hospital, the components of such a programme and the evidence base for its implementation. Sources: National and society-led guidelines on AMS, peer-reviewed publications and experience of AMS experts conducting AMS programmes. Content: We provide a step-by-step pragmatic guide to setting up and implementing a hospital AMS programme in high-income or low-and-middle-income countries. Implications: Antimicrobial stewardship programmes in hospitals are a vital component of national action plans for AMR, and have been shown to significantly reduce AMR, particularly when coupled with infection prevention and control interventions. This step-by-step guide of 'how to' set up an AMS programme will help health-care professionals involved in AMS to optimally design and implement their actions.

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“…‘what is’) and ideal state (i.e. ‘what should be’), as means to better understand the educational needs of HCPs that can be addressed through continuous medical education (CME) 16 and professional development (CPD) activities. 9 Barriers contributing to identified gaps were explored across multiple levels (i.e.…”

Section: Methodsmentioning

confidence: 99%

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

Lazure

Augustyniak

Goff

et al. 2022

JAC-Antimicrobial Resistance

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Background Evidence shows limited adherence to antimicrobial stewardship (AMS) principles. Objectives To identify educational gaps and systemic barriers obstructing adherence to AMS principles. Methods A mixed-methods study combining a thematic analysis of qualitative interviews (January–February 2021) and inferential analysis of quantitative surveys (May–June 2021) was conducted. Participants from France, the USA, Mexico and India were purposively sampled from online panels of healthcare professionals to include infectious disease physicians, infection control specialists, clinical microbiologists, pharmacologists or pharmacists expected to apply AMS principles in their practice setting (e.g. clinic, academic-affiliated or community-based hospital). A gap analysis framework guided this study. Results The final sample included 383 participants (n = 33 interviews; n = 350 surveys). Mixed-methods findings indicated suboptimal knowledge and skills amongst participants to facilitate personal and collective application of AMS principles. Survey data indicated a gap in ideal versus current knowledge of AMS protocols, especially amongst pharmacologists (Δ0.95/4.00, P < 0.001). Gaps in ideal versus current skill levels were also measured and were highest amongst infectious control specialists (Δ1.15/4.00, P < 0.001), for convincing hospital executives to allocate resources to AMS programmes. Already existing systemic barriers (e.g. insufficient dedicated time/funding/training) were perceived as being aggravated during the COVID-19 pandemic (72% of survey participants agreed). Reported gaps were highest in India and France. Conclusions The educational needs of professionals and countries included in this study can inform future continuous professional development activities in AMS. Additional funding should be considered to address perceived systemic barriers. Local assessments are warranted to validate results and suitability of interventions.

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Legal framework of antimicrobial stewardship in hospitals (LEASH): a European Society of Clinical Microbiology and Infectious Diseases (ESCMID) cross-sectional international survey

Cited by 9 publications

References 14 publications

Organization and training at national level of antimicrobial stewardship and infection control activities in Europe: an ESCMID cross-sectional survey

Organization and training at national level of antimicrobial stewardship and infection control activities in Europe: an ESCMID cross-sectional survey

How to start an antimicrobial stewardship programme in a hospital

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

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