Enani Mushira A
Infectious Diseases Section, Department of Medicine, King Fahad Medical City, Riyadh, Saudi Arabia.
J Infect Prev. 2016 Jan;17(1):16-20. doi: 10.1177/1757177415611220. Epub 2015 Oct 8.
The purpose of the current study is to describe the prevalence and characteristics of antimicrobial stewardship programs (ASP) in Gulf Cooperation Council (GCC) states to explore opportunities and overcome barriers to effective ASP implementation.
A cross-sectional questionnaire survey was used to evaluate the current status of ASP: major stewardship components, barriers of implementation and program impact in acute care hospitals of GCC states.
Forty-seven healthcare professionals responded from four GCC states, the majority from Saudi Arabia (81%). Twenty-nine (62%) participating hospitals had ASP in place. Of these established programs, 35 (75%) reported lack of funding and personnel as major barriers to program implementation. The top three objectives cited for the hospital ASP were to reduce resistance (72.3%), improve clinical outcomes (70.2%) and reduce costs (44.7%). The reported impact of existing ASP was reduction of inappropriate prescribing (68%), reduction of broad spectrum antibiotic use (63.8%), reduction of healthcare-associated infections (61.7%), reduction of length of stay or mortality metrics (59.6%), reduction in direct antibiotic cost (57.4%) and reduction of reported antibiotic resistance (55.3%).
Survey participants from GCC states who have implemented ASP report significant impacts in the reduction of broad spectrum antibiotic use, hospital-acquired infection, inappropriate prescribing and antimicrobial resistance. These findings suggest a promising opportunity to enhance existing ASP through sharing of best practices and support the development of regional guidelines across GCC states.
本研究旨在描述海湾合作委员会(GCC)国家抗菌药物管理计划(ASP)的流行情况和特征,以探索有效实施ASP的机会并克服障碍。
采用横断面问卷调查来评估ASP的现状:GCC国家急性护理医院中的主要管理组成部分、实施障碍和计划影响。
来自四个GCC国家的47名医疗保健专业人员做出了回应,其中大多数来自沙特阿拉伯(81%)。29家(62%)参与调查的医院已实施ASP。在这些已建立的计划中,35家(75%)报告称资金和人员短缺是计划实施的主要障碍。医院ASP提到的前三大目标是降低耐药性(72.3%)、改善临床结果(70.2%)和降低成本(44.7%)。报告的现有ASP的影响包括减少不适当处方(68%)、减少广谱抗生素使用(63.8%)、减少医疗相关感染(61.7%)、缩短住院时间或降低死亡率指标(59.6%)、降低直接抗生素成本(57.4%)以及降低报告的抗生素耐药性(55.3%)。
来自GCC国家已实施ASP的调查参与者报告称,在减少广谱抗生素使用、医院获得性感染、不适当处方和抗菌药物耐药性方面有显著影响。这些发现表明,通过分享最佳实践来加强现有ASP并支持制定GCC国家区域指南存在着一个有前景的机会。