Leung Valerie, Quirk Jacquelyn, Muir Sarah, Daneman Nick, Schwartz Kevin L, Langford Bradley J
Public Health Ontario, Toronto, ON, Canada.
Toronto East Health Network, Michael Garron Hospital, Toronto, ON, Canada.
JAC Antimicrob Resist. 2022 Dec 29;5(1):dlac134. doi: 10.1093/jacamr/dlac134. eCollection 2023 Feb.
Antimicrobial resistance (AMR) continues to be a global public health issue amid the COVID-19 pandemic; however, unprecedented demands on hospital antimicrobial stewardship programmes (ASPs) potentially altered their core activities.
We sought to understand how ASPs have been involved in and impacted by the pandemic.
The 2021 Ontario ASP Landscape Survey was developed based on previous provincial questionnaires and emerging literature on the impact of COVID-19 on hospital ASPs. After pre-testing and piloting, the online questionnaire was distributed to hospital antimicrobial stewardship practitioners in the fall of 2021. Descriptive statistics and inductive thematic analysis were performed.
The response rate was 78% (98/125 organizations); 96% (94/98) of organizations had or were in the process of formalizing an ASP and 53% (50/94) reported designated funding/resources. Despite 82% reporting no change in dedicated full-time equivalents during the pandemic, ASPs were frequently involved in developing treatment guidelines/clinical pathways (51%), anticipating/managing drug shortages (46%) and obtaining investigational use drugs (32%). While many core ASP activities continued, prospective audit and feedback and prescriber education were modified or suspended by 43% and 40% of programmes, respectively. Decreased frequency, adaptation of activities (i.e. virtual or other technology) and challenges with staffing/resources were commonly reported themes. Knowledge translation (KT) activities and 'collaboration and coordination' also emerged as salient themes.
Hospital antimicrobial stewardship practitioners in Ontario have made significant contributions to the pandemic response while continuing to deliver adapted ASP services, despite resource constraints. Moving forward, ASPs will need to continue building capacity while leveraging broader networks to advance the antimicrobial stewardship agenda.
在新冠疫情期间，抗菌药物耐药性（AMR）仍是一个全球公共卫生问题；然而，对医院抗菌药物管理计划（ASPs）前所未有的需求可能改变了其核心活动。
我们试图了解抗菌药物管理计划是如何参与到疫情中以及受到疫情影响的。
2021年安大略省抗菌药物管理计划概况调查基于以往的省级调查问卷以及关于新冠疫情对医院抗菌药物管理计划影响的新文献制定。经过预测试和试点后，在线问卷于2021年秋季分发给医院抗菌药物管理从业者。进行了描述性统计和归纳主题分析。
回复率为78%（98/125个组织）；96%（94/98）的组织拥有或正在制定正式的抗菌药物管理计划，53%（50/94）报告有指定资金/资源。尽管82%的组织报告在疫情期间专职等效人员数量没有变化，但抗菌药物管理计划经常参与制定治疗指南/临床路径（51%）、预测/管理药品短缺（46%）以及获取研究用药物（32%）。虽然许多抗菌药物管理计划的核心活动仍在继续，但分别有43%和40%的计划修改或暂停了前瞻性审核与反馈以及开方者教育。活动频率降低、活动调整（即采用虚拟或其他技术）以及人员配备/资源方面的挑战是常见的报告主题。知识转化（KT）活动以及“协作与协调”也成为突出主题。
安大略省的医院抗菌药物管理从业者在资源有限的情况下，为应对疫情做出了重大贡献，同时继续提供适应性的抗菌药物管理计划服务。展望未来，抗菌药物管理计划需要在利用更广泛网络推进抗菌药物管理议程的同时继续建设能力。
