Six years of a national antimicrobial stewardship programme in Scotland: where are we now?

Abstract

BackgroundThe Scottish Antimicrobial Prescribing Group (SAPG) was established in 2008 to lead delivery of the national antimicrobial stewardship programme. We performed a national self-reported survey in 2014 to evaluate stewardship activities delivered by regional Antimicrobial Management Teams (AMTs). An on-line survey was developed utilising validated indicators from a published European study along with questions specific to the Scottish context. Descriptive statistics were used to evaluate the responses received.FindingsThe survey was completed by 14 of the 15 AMTs (response rate 93 %). Results demonstrated good compliance with 9 of the 10 key European indicators included in the survey; 7 (50 %) of AMTs achieved all 9 indicators and 14 (100 %) of AMTs achieved at least 6 out of 9 indicators (67 %). Progress was also demonstrated across a range of stewardship activities and areas for further work were identified.ConclusionsThe survey results suggest the national stewardship programme in Scotland has reached maturity but consolidation and ongoing development are required. Collaborative working between SAPG and AMTs together with central funding has been key to achieving this level of success.

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“…60 In Scotland, the Government funded the Scottish Antimicrobial Prescribing Group, which successfully reduced rates of C diffi cile infection, 61 stabilised antibiotic resistance, and introduced national and local prescribing metrics with feedback to mandate appropriate antibiotic use. 62 In 2016, national antibiotic toolkits and guidance around the antibiotic practice, systems, and processes were introduced (table ). 63…”

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“…1,140 Delivery of institution-or unit-specific antimicrobial consumption data can engage prescribers and improve compliance with guidelines. 145,146 Verbal and written feedback, ideally including explicit targets and action plans, are valuable. 147 Local antibiotic treatment guidelines should include recommendations for treatment of proven and suspected infections caused by CRE.…”

“…Ideally, detailed antimicrobial consumption trends should be available, as is the case in Europe and Canada 1 140 Delivery of institution- or unit-specific antimicrobial consumption data can engage prescribers and improve compliance with guidelines 145 146 Verbal and written feedback, ideally including explicit targets and action plans, are valuable 147 …”

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“…4.2.9 UK: Scotland Colligan et al 2015) We have previously documented the initiation and activities of SAPG in Scotland (Sect. 4.1), which significantly reduced Clostridium difficile infection rates.…”