Department of Medicine, University of Melbourne, Melbourne, VIC, Australia.
Med J Aust. 2013 Nov 18;199(10):692-5. doi: 10.5694/mja13.10422.
To determine antimicrobial stewardship (AMS) activities currently being undertaken at Victorian hospitals, identifying gaps when assessed against the Australian Commission on Safety and Quality in Health Care criteria for effective AMS.
DESIGN, SETTING AND PARTICIPANTS: A survey open to all Victorian health services, conducted between January and March 2012.
Availability of the endorsed prescribing guidelines, antimicrobial prescribing policies, formularies, approval systems for restricted antimicrobials, procedures for postprescription review, auditing and selective reporting of sensitivities.
Response rates were 96.4% for public health services and 67.7% for private hospitals. Guidelines were available at all public and 88.1% of private hospitals, and 90.6% of public metropolitan, 45.7% of public regional and 21.4% of private hospitals had antimicrobial prescribing policies. Antimicrobial approval systems were used in 93.8% of public metropolitan, 17.3% of public regional and 4.8% of private hospitals. Prescribing audits were conducted by 62.5% of public metropolitan, 35.8% public regional and 52.4% of private hospitals. Nearly all hospitals had selective laboratory reporting of antimicrobial sensitivities. Few hospitals had dedicated funding for AMS personnel.
We identified wide differences between hospital AMS activities. Additional support for AMS is particularly required in the public regional and private hospital sectors, principally in the key areas of policy development, antimicrobial approval systems, prescription review and auditing. Further research is required to develop recommendations for implementation of AMS within the regional and private hospital settings.
确定维多利亚州医院目前正在开展的抗菌药物管理（AMS）活动，根据澳大利亚安全与质量卫生保健委员会（Australian Commission on Safety and Quality in Health Care）对有效 AMS 的标准，评估这些活动是否存在差距。
设计、地点和参与者：这项针对所有维多利亚州卫生服务机构的调查于 2012 年 1 月至 3 月进行。
已认可的处方指南、抗菌药物处方政策、处方集、限制使用抗菌药物的批准制度、处方后审查程序、审核和药敏选择性报告的可用性。
公立卫生服务机构的回复率为 96.4%，私立医院的回复率为 67.7%。公立和 88.1%的私立医院均提供指南，90.6%的公立大都市、45.7%的公立地区和 21.4%的私立医院制定了抗菌药物处方政策。93.8%的公立大都市、17.3%的公立地区和 4.8%的私立医院使用了抗菌药物批准制度。62.5%的公立大都市、35.8%的公立地区和 52.4%的私立医院开展了处方审核。几乎所有医院都进行了选择性的实验室报告抗菌药物敏感性。很少有医院有专门用于 AMS 人员的资金。
我们发现医院的 AMS 活动之间存在很大差异。特别是在公立地区和私立医院部门，需要在政策制定、抗菌药物批准制度、处方审查和审核等关键领域进一步支持 AMS。需要进一步研究，为区域和私立医院环境中实施 AMS 提出建议。
