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Implementation of antibiotic stewardship in different settings - results of an international survey

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Title: Implementation of antibiotic stewardship in different settings - results of an international survey
Authors: Charani, E
Castro-Sanchez, E
Bradley, S
Nathwani, D
Holmes, A
Davey, P
Item Type: Journal Article
Abstract: Background Antibiotic stewardship interventions are being implemented across different healthcare settings. We report the findings of a global survey of healthcare professionals on the implementation of antibiotic stewardship programmes. Methods Learners of a Massive Online Open Course (MOOC) on antibiotic stewardship were invited to complete an online survey on the core available organisational resources for stewardship. The categorical variables were analysed using chi-squared test, and Likert questions were analysed using an ordinal regression model. The p-values were considered as two-tailed. Significance was set at p-value of < 0.05. Results The response rate was 55% (505/920), from 53 countries. The responders were 36% (182) doctors, 26% (130) pharmacists, 18% (89) nurses and 20% (104) other (researchers, students and members of the public). Post-graduate training in infection management and stewardship was reported by 56% of doctors compared with 43% (OR 0.59, 95%CI 0.35–1.00) nurses and 35% (OR 0.39, 95%CI 0.24–0.62) of pharmacists. Hospitals were significantly (83% in teaching hospitals, 79% in regional hospitals, p = < 0.01) more likely to have antibiotic policies, when compared to primary care. A surveillance mechanism for antibiotic consumption was reported in 58% (104/178) of teaching hospitals and 62% (98/159) of regional hospitals. Antimicrobial resistance, patient needs, policy, peer influence and specialty level culture and practices were deemed important determinants for decision-making. Conclusion Postgraduate training and support in antibiotic prescribing remains low amongst nurses and pharmacists. Whilst antibiotic policies and committees are established in most institutions, surveillance of antibiotic use is not. The impact of specialty level culture, and peer influence appears to be important factors of antibiotic prescribing.
Issue Date: 12-Feb-2019
Date of Acceptance: 4-Feb-2019
URI: http://hdl.handle.net/10044/1/67404
DOI: https://dx.doi.org/10.1186/s13756-019-0493-7
ISSN: 2047-2994
Publisher: BioMed Central
Journal / Book Title: Antimicrobial Resistance and Infection Control
Volume: 8
Copyright Statement: © The Author(s). 2019. This article is distributed under the terms of the Creative Commons Attribution 4.0International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, andreproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link tothe Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver(http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Sponsor/Funder: National Institute for Health Research
National Institute for Health Research
ESRC
Funder's Grant Number: HPRU-2012-10047
HPRU-2012-10047
Keywords: Science & Technology
Life Sciences & Biomedicine
Public, Environmental & Occupational Health
Infectious Diseases
Microbiology
Antibiotic stewardship
Education
Culture
Antibiotic prescribing
Publication Status: Published
Article Number: ARTN 34
Appears in Collections:Department of Medicine
Faculty of Medicine



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