Systematic review of factors promoting behaviour change toward antibiotic use in hospitals

Pouly, Emilie; Coppry, Maïder; Rogues, Anne-Marie; Dumartin, C.

doi:10.1016/j.cmi.2022.01.005

Cited by 6 publications

(3 citation statements)

References 29 publications

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“…In a French study, the most common subcategories of enablement were audit and feedback [ 26 ]. In a recent study, the authors found that audit and feedback are a feasible and valuable methodology to assess the nationwide implementation of antibiotic stewardship programmes in hospitals [ 27 ]. Furthermore, it can identify relevant targets for the improvement of such programmes [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

The Impact of National Activities on Antibiotic Consumption in Hospitals and Different Departments over a 14-Year Period

Čižman,

Kastrin,

Beović

et al. 2024

Antibiotics

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The aim of this study was to assess the use of antibiotics in hospitals and different departments over 14 years (2006–2019) and the impact of various national activities related to this, including national audits of the use of antibiotics for systemic use. The consumption of antibiotics for systemic use (J01) from all Slovenian hospitals (n = 29) and five departments (internal medicine, surgery, ICU (medicine, surgery), paediatrics and gynaecology/obstetrics) was collected. Total hospital consumption was expressed as the number of defined daily doses (DDDs) per 1000 inhabitants per day (DID), the number of DDDs/100 bed days and the number of DDDs/100 admissions. Over 14 years, J01 hospital consumption increased by 13.8%, expressed in DDDs/100 bed days (p = 0.002). In 2019, compared to 2006, the consumption of J01, expressed in DDD/100 bed days, increased from 19.9% to 33.1% in all departments, except intensive care units. J01 consumption expressed in DDD/100 admissions increased by 7.0% to 39.4% in all but paediatric wards (where it decreased by 12.7%). In all years, we observed large variations in the consumption of antibiotics in departments of the same type. The effectiveness of audit interventions aimed at optimizing antibiotic consumption exhibited notable variation across hospitals, with specialized facilities generally demonstrating superior outcomes compared to general hospitals.

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Section: Discussionmentioning

confidence: 99%

The Impact of National Activities on Antibiotic Consumption in Hospitals and Different Departments over a 14-Year Period

Čižman,

Kastrin,

Beović

et al. 2024

Antibiotics

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“…Here another aspect of AMS is in demand: the psychological point which extends beyond simple recommendations. A rationale use of antibiotics often implies a behavioural change [ 17 – 20 ].…”

Section: Discussionmentioning

confidence: 99%

Choosing Wisely internationally – helpful recommendations for antimicrobial stewardship!

2023

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Purpose Antimicrobial resistance poses a major threat to human health globally and antibiotic overuse is a main driver of resistance. Antimicrobial stewardship (AMS) was developed to improve the rationale use of antibiotics. The Choosing Wisely campaign was initiated to ameliorate medical practice through avoidance of unnecessary diagnostic and therapeutic procedures. Our objective was to give an overview on the Choosing Wisely recommendations related to AMS practices from a selection of different countries in order to define future needs. Methods We evaluated the seven countries already analyzed for Choosing Wisely recommendations related to topics of infectious medicine before. Finally, we included five of the former countries (Australia/New Zealand, Canada, Italy, Switzerland, and USA) and Germany with easily accessible recommendations and selected those related to six categories of AMS as following: diagnostics, indication, choice of antiinfective drugs, dosing, application and duration of therapy. Results In total, 213 recommendations could be extracted related to AMS for the six countries and were matched to the chosen categories. Interestingly, no recommendations were found for the category “dosing.” Topics related to indication and diagnostics were most frequently found with 85 and 78 recommendations, respectively. Perioperative prophylaxis was a frequently addressed issue – both related to application, indication and duration. Avoiding antibiotic treatment of asymptomatic bacteriuria and upper respiratory tract infections were central topics of all countries. Conclusion AMS is an important strategy to fight increasing resistance and is frequently addressed by Choosing Wisely recommendations of different countries. Similar issues are considered important in the selected countries.

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“… 25 There is now agreement that only long-term and multifaceted interventions can lead to behaviour changes an improvement in prescribing. 26 These long-term engagements should be flanked by regular educational activities and point-prevalence studies to identify areas for improvement. 27 …”

Section: Discussionmentioning

confidence: 99%

Implementation of an antimicrobial stewardship programme in three regional hospitals in the south-east of Liberia: lessons learned

Alabi

Picka

Sirleaf

et al. 2022

JAC-Antimicrobial Resistance

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Background Antimicrobial stewardship (AMS) programmes can improve the use of antimicrobial agents. However, there is limited experience in the implementation of such programmes in low- and middle-income countries (LMICs). Objectives To assess the effect of AMS measures in south-east Liberia on the quality of antimicrobial use in three regional hospitals. Methods A bundle of three measures (local treatment guideline, training and regular AMS ward rounds) was implemented and quality indicators of antimicrobial use (i.e. correct compounds, dosage and duration) were assessed in a case series before and after AMS ward rounds. Primary endpoints were (i) adherence to the local treatment guideline; (ii) completeness of the microbiological diagnostics (according to the treatment guideline); and (iii) clinical outcome. The secondary endpoint was reduction in ceftriaxone use. Results The majority of patients had skin and soft tissue infections (n = 108) followed by surgical site infections (n = 72), pneumonia (n = 64), urinary tract infection (n = 48) and meningitis (n = 18). After the AMS ward rounds, adherence to the local guideline improved for the selection of antimicrobial agents (from 34.5% to 61.0%, P < 0.0005), dosage (from 15.2% to 36.5%, P < 0.0005) and duration (from 13.2% to 31.0%, P < 0.0005). In total, 79.7% of patients (247/310) had samples sent for microbiological analysis. Overall, 92.3% of patients improved on Day 3 (286/310). The proportion of patients receiving ceftriaxone was significantly reduced after the AMS ward rounds from 51.3% to 14.2% (P < 0.0005). Conclusions AMS measures can improve the quality of antimicrobial use in LMICs. However, long-term engagement is necessary to make AMS programmes in LMICs sustainable.

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Systematic review of factors promoting behaviour change toward antibiotic use in hospitals

Cited by 6 publications

References 29 publications

The Impact of National Activities on Antibiotic Consumption in Hospitals and Different Departments over a 14-Year Period

The Impact of National Activities on Antibiotic Consumption in Hospitals and Different Departments over a 14-Year Period

Choosing Wisely internationally – helpful recommendations for antimicrobial stewardship!

Implementation of an antimicrobial stewardship programme in three regional hospitals in the south-east of Liberia: lessons learned

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