Khan F, Arthur J, Maidment L, Blue D
Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, Ottawa, ON.
Office of the Chief Medical Officer of Health, Edmonton, AB.
Can Commun Dis Rep. 2016 Nov 3;42(11):238-241. doi: 10.14745/ccdr.v42i11a04.
Antimicrobial resistance (AMR) is recognized as an important global public health concern that has a cross-cutting impact on human health, animal health, food and agriculture and the environment. The Communicable and Infectious Disease Steering Committee (CIDSC) of the Pan-Canadian Public Health Network (PHN) created a Task Group on Antimicrobial Stewardship to look at this issue from a Canadian perspective.
To summarize the key findings of the Task Group Report that identified core components of antimicrobial stewardship programs, best practices, key challenges, gaps and recommendations to advance stewardship across jurisdictions.
Search strategies were developed to identify scientific literature, grey literature and relevant websites on antimicrobial stewardship. The information was reviewed and based on this evidence, expert opinion and consensus-building, the Task Group identified core components, best practices, key challenges and gaps and developed recommendations to advance stewardship in Canada.
The four components of a promising antimicrobial stewardship initiative were: leadership, interventions, monitoring/evaluation and future research. Best practices include a multi-sectoral/multipronged approach involving a wide range of stakeholders at the national, provincial/territorial, local and health care organizational levels. Key challenges and gaps identified were: the success and sustainability of stewardship undertakings require appropriate and sustained resourcing and expertise; there is limited evidence about how to effectively implement treatment guidance; and there is a challenge in ensuring accessibility, standardization and consistency of use among professionals. Recommendations to the CIDSC about how to advance stewardship across jurisdictions included the following: institute a national infrastructure; develop best practices to implement stewardship programs; develop education and promote awareness; establish consistent evidence-based guidance, resources, tools and training; mandate the incorporation of stewardship education; develop audit and feedback tools; establish benchmarks and performance targets for stewardship; and conduct timely evaluation of stewardship programs.
Findings of this report will inform a more systematic approach to addressing antimicrobial stewardship Canada-wide.
抗菌药物耐药性（AMR）被视为一个重要的全球公共卫生问题，对人类健康、动物健康、食品与农业以及环境具有交叉影响。泛加拿大公共卫生网络（PHN）的传染病与感染病指导委员会（CIDSC）成立了一个抗菌药物管理任务组，从加拿大的角度审视这一问题。
总结任务组报告的主要发现，该报告确定了抗菌药物管理计划的核心组成部分、最佳实践、主要挑战、差距以及推进各辖区管理工作的建议。
制定检索策略，以识别有关抗菌药物管理的科学文献、灰色文献和相关网站。对这些信息进行了审查，并基于此证据、专家意见和共识构建，任务组确定了核心组成部分、最佳实践、主要挑战和差距，并制定了推进加拿大管理工作的建议。
一项有前景的抗菌药物管理倡议的四个组成部分是：领导力、干预措施、监测/评估和未来研究。最佳实践包括多部门/多管齐下的方法，涉及国家、省/地区、地方和医疗保健组织层面的广泛利益相关者。确定的主要挑战和差距包括：管理工作的成功与可持续性需要适当和持续的资源及专业知识；关于如何有效实施治疗指南的证据有限；在确保专业人员使用的可及性、标准化和一致性方面存在挑战。向CIDSC提出的关于如何在各辖区推进管理工作的建议包括以下内容：建立国家基础设施；制定实施管理计划的最佳实践；开展教育并提高认识；建立一致的循证指南、资源、工具和培训；强制纳入管理教育；开发审计和反馈工具；为管理工作设定基准和绩效目标；并及时评估管理计划。
本报告的结果将为在全加拿大以更系统的方法应对抗菌药物管理提供参考。
