Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore; Department of Infectious Diseases, National Centre for Infectious Diseases, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asia Pacific Foundation for Infectious Diseases, Seoul, Republic of Korea.
J Glob Antimicrob Resist. 2021 Mar;24:387-394. doi: 10.1016/j.jgar.2021.01.013. Epub 2021 Feb 3.
Antimicrobial stewardship is a strategy to combat antimicrobial resistance in hospitals. Given the burden and impact of antimicrobial resistance in the Asia Pacific, it is important to document capacity and gaps in antimicrobial stewardship programmes (ASP). We aimed to understand existing capacities and practices, and define the resources needed to establish antimicrobial stewardship where it is lacking.
An anonymous online survey, consisting of questions on antimicrobial control at country, hospital and programme levels, was circulated to healthcare providers in the field of infectious diseases and microbiology through Asian Network for Surveillance of Resistant Pathogens, ReAct Group and the Australasian Society for infectious Diseases.
139 participants from 16 countries or regions completed the survey. The majority of participants were adult infectious diseases physicians (61/139, 43.9%) and microbiologists (31/139, 22.3%). Participants from 7 countries reported that antimicrobials can be obtained without prescriptions. Despite the high percentage (75.5%) of respondents working in large hospitals, only 22/139 participants (15.8%) from Australia, China, Singapore, Taiwan, Thailand and Vietnam reported having more than 10 infectious diseases physicians. Hospital empiric antimicrobial guidelines for common infections were available according to 110/139 (79.1%) participants. Pre-authorisation of antimicrobials was reported by 88/113 (77.9%) respondents while prospective audit and feedback was reported by 93/114 (81.6%). Automatic stop orders and culture-guided de-escalation were reported by only 52/113 (46.0%) and 27/112 (24.1%) respectively.
The survey reveals a wide range of ASP development in Asia Pacific. Establishing national workgroups and guidelines will help advance antimicrobial stewardship in this diverse region.
抗菌药物管理是对抗医院内抗菌药物耐药性的一种策略。鉴于亚太地区抗菌药物耐药性的负担和影响，记录抗菌药物管理计划（ASP）的现有能力和差距非常重要。我们旨在了解现有的能力和实践，并确定在缺乏抗菌药物管理的地方建立抗菌药物管理所需的资源。
通过亚洲耐药病原体监测网络、ReAct 小组和澳大利亚传染病学会向传染病和微生物学领域的医疗保健提供者分发了一份匿名在线调查，其中包括国家、医院和项目各级抗菌控制的问题。
来自 16 个国家或地区的 139 名参与者完成了调查。大多数参与者是成人传染病医师（61/139，43.9%）和微生物学家（31/139，22.3%）。来自 7 个国家的参与者报告称，无需处方即可获得抗生素。尽管有很高比例（75.5%）的受访者在大医院工作，但来自澳大利亚、中国、新加坡、中国台湾、泰国和越南的仅 22/139 名参与者（15.8%）报告称拥有超过 10 名传染病医师。110/139 名（79.1%）参与者报告说，有针对常见感染的医院经验性抗菌药物指南。88/113（77.9%）受访者报告了抗生素的预授权，93/114（81.6%）报告了前瞻性审核和反馈。仅有 52/113（46.0%）和 27/112（24.1%）的受访者分别报告了自动停药医嘱和基于培养的降阶梯治疗。
调查显示亚太地区的 ASP 发展范围广泛。建立国家工作组和指南将有助于推进这个多样化地区的抗菌药物管理。
