Researchers propose key elements of antimicrobial stewardship for hospitals worldwide

Antimicrobial stewardship programs (ASPs) in hospitals play a vital role in managing the threat of antibiotic resistance. To be of maximum effectiveness, essential elements of ASP programs need to be identified and standardized. Previous efforts in identifying the key components of ASPs have been confined to high-income countries. In a study to be published in the journal Clinical Microbiology and Infection, researchers identify essential elements of ASPs that could be applicable to hospitals in both high-income and low-income countries.

Researchers from Center for Disease Dynamics, Economics & Policy (CDDEP) and the Université de Lorraine in France conducted the study with the help of 15 experts from 13 countries in six continents. Through a consensus process, seven core elements that included 29 checklist items were identified. The seven core elements - leadership commitment, accountability, drug expertise, action, tracking, reporting, and education - are relevant across resource-rich and resource-limited settings. The researchers concluded that the next step should be to evaluate these core elements in a range of geographic and resource settings with broader stakeholder groups.

"An agreement of this nature will make a major contribution to slowing the spread of antibiotic resistance," said CDDEP fellow and study co-author Sumanth Gandra. "It will also facilitate the development of each nation's antimicrobial stewardship guidelines, especially in low income countries."

"With standardized ASP guidelines, analysis and evaluation of the programs will also be possible, which is an essential part of fine-tuning the practices and learning from one another," according to Celine Pulcini of the Université de Lorraine.

Pulcini C, Binda F, Lamkang AS, Trett A, Charani E, Goff DA, Harbarth S, Hinrichsen SL, Levy-Hara G, Mendelson M, Nathwani D, Gunturu R, Singh S, Srinivasan A, Thamlikitkul V, Thursky K, Vlieghe E, Wertheim H, Zeng M, Gandra S, Laxminarayan R.
Developing core elements and checklist items for global hospital antimicrobial stewardship programmes: a consensus approach.
Clinical Microbiology and Infection, (2018). doi: 10.1016/j.cmi.2018.03.033.

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