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A cross‐sectional survey of antimicrobial stewardship strategies in UK hospitals
Author(s) -
Tonna A. P.,
Gould I. M.,
Stewart D.
Publication year - 2014
Publication title -
journal of clinical pharmacy and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.622
H-Index - 73
eISSN - 1365-2710
pISSN - 0269-4727
DOI - 10.1111/jcpt.12181
Subject(s) - antimicrobial stewardship , medicine , antimicrobial , pharmacy , family medicine , pharmacist , cross sectional study , audit , antibiotic resistance , antibiotics , business , chemistry , accounting , organic chemistry , microbiology and biotechnology , biology , pathology
Summary What is known and objective Antimicrobial stewardship programmes describe strategies to optimize antimicrobial prescribing and utilization, minimize resistance and improve patient outcomes. Strategies in hospitals are usually implemented by multidisciplinary antimicrobial teams ( AMT s). The objective of this study was to describe the profile and activities of AMT s within hospitals in the U nited K ingdom ( UK ). Method All hospitals within the UK ( n = 836) were included, and a prepiloted questionnaire was mailed to the ‘Director of Pharmacy’. Non‐respondents were mailed up to two reminder questionnaires at two‐weekly intervals. Main outcome measures are as follows: existence and remit of the AMT s; availability of antimicrobial‐prescribing policies, aims, scope and methods of dissemination; and monitoring and feedback provided on antimicrobial policy adherence. Results Response rate was 33% ( n = 273). Completed questionnaires analysed were n = 226. Eighty‐two ( n = 186) of respondents indicated the presence of an AMT within the hospital, with 95% of these ( n = 177) reporting an antimicrobial pharmacist as part of the team. All AMT s ( n = 186) were involved in development of an antimicrobial policy and almost all (99% n = 184) promoted adherence and restricting use of specific antimicrobials (97% n = 180). Ninety‐eight per cent of respondents ( n = 222) reported the availability of a local antimicrobial‐prescribing policy within the hospital with this disseminated mainly through the hospital intranet (98% n = 217). Adherence to policy was measured mainly through audits measuring the appropriateness of antimicrobial use against the local policy (76% n = 169). Hospitals in E ngland ( P = 0·010), tertiary care hospitals ( P = 0·021) and bed capacity >500 ( P < 0·001) were more likely to have an AMT , as were hospitals with an accident and emergency department ( P < 0·001), an infectious diseases unit ( P = 0·019) and a microbiology department ( P < 0·001). Audits to measure policy adherence were more likely ( P < 0·001) if an AMT was present. The only variable retained in bivariate logistic regression was the presence of a microbiology unit, with an odds ratio of 14·1 (95% CI 6·02–33·33, P < 0·001). What is new and conclusions Although most respondents reported an antimicrobial‐prescribing policy, less had an AMT . Despite recent government and regional initiatives, further improvements in antimicrobial stewardship are still required.