White Paper: Bridging the gap between human and animal surveillance data, antibiotic policy and stewardship in the hospital sector-practical guidance from the JPIAMR ARCH and COMBACTE-MAGNET EPI-Net networks.
Journal
The Journal of antimicrobial chemotherapy
ISSN: 1460-2091
Titre abrégé: J Antimicrob Chemother
Pays: England
ID NLM: 7513617
Informations de publication
Date de publication:
06 12 2020
06 12 2020
Historique:
entrez:
6
12
2020
pubmed:
7
12
2020
medline:
25
6
2021
Statut:
ppublish
Résumé
Antimicrobial surveillance and antimicrobial stewardship (AMS) are essential pillars in the fight against antimicrobial resistance (AMR), but practical guidance on how surveillance data should be linked to AMS activities is lacking. This issue is particularly complex in the hospital setting due to structural heterogeneity of hospital facilities and services. The JPIAMR ARCH and COMBACTE-MAGNET EPI-Net networks have joined efforts to formulate a set of target actions for linking surveillance data with AMS activities. A scoping review of the literature was carried out addressing research questions on three areas: (i) AMS leadership and accountability; (ii) antimicrobial usage and AMS; (iii) AMR and AMS. Consensus on the target actions was reached through a RAND-modified Delphi process involving over 40 experts in different fields from 18 countries. Evidence was retrieved from 51 documents. Initially 38 targets were proposed, differentiated as essential or desirable according to clinical relevance, feasibility and applicability to settings and resources. In the first consultation round, preliminary agreement was reached for 32 targets. Following a second consultation, 27 targets were approved, 11 were deleted and 4 were suggested for rephrasing, leading to a final approved list of 34 target actions in the form of a practical checklist. This White Paper provides a pragmatic and flexible tool to guide the development of calibrated hospital-surveillance-based AMS interventions. The strength of this tool is that it is a comprehensive perspective that takes into account the hospital patient case-mix and the related epidemiology, which ultimately drives antimicrobial usage, and the feasibility in low-resource settings.
Sections du résumé
BACKGROUND
Antimicrobial surveillance and antimicrobial stewardship (AMS) are essential pillars in the fight against antimicrobial resistance (AMR), but practical guidance on how surveillance data should be linked to AMS activities is lacking. This issue is particularly complex in the hospital setting due to structural heterogeneity of hospital facilities and services. The JPIAMR ARCH and COMBACTE-MAGNET EPI-Net networks have joined efforts to formulate a set of target actions for linking surveillance data with AMS activities.
METHODS
A scoping review of the literature was carried out addressing research questions on three areas: (i) AMS leadership and accountability; (ii) antimicrobial usage and AMS; (iii) AMR and AMS. Consensus on the target actions was reached through a RAND-modified Delphi process involving over 40 experts in different fields from 18 countries.
RESULTS
Evidence was retrieved from 51 documents. Initially 38 targets were proposed, differentiated as essential or desirable according to clinical relevance, feasibility and applicability to settings and resources. In the first consultation round, preliminary agreement was reached for 32 targets. Following a second consultation, 27 targets were approved, 11 were deleted and 4 were suggested for rephrasing, leading to a final approved list of 34 target actions in the form of a practical checklist.
CONCLUSIONS
This White Paper provides a pragmatic and flexible tool to guide the development of calibrated hospital-surveillance-based AMS interventions. The strength of this tool is that it is a comprehensive perspective that takes into account the hospital patient case-mix and the related epidemiology, which ultimately drives antimicrobial usage, and the feasibility in low-resource settings.
Identifiants
pubmed: 33280046
pii: 6024989
doi: 10.1093/jac/dkaa426
pmc: PMC7719407
doi:
Substances chimiques
Anti-Bacterial Agents
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
ii20-ii32Informations de copyright
© The Author(s) 2020. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy.
Références
J Antimicrob Chemother. 2016 Apr;71(4):1106-17
pubmed: 26747104
J Antimicrob Chemother. 2018 Jun 1;73(suppl_6):vi50-vi58
pubmed: 29878222
Clin Microbiol Infect. 2013 Feb;19(2):141-60
pubmed: 22117544
J Antimicrob Chemother. 2018 Jun 1;73(suppl_6):vi30-vi39
pubmed: 29878221
Clin Infect Dis. 2018 Sep 28;67(8):1168-1174
pubmed: 29590355
Open Forum Infect Dis. 2018 May 24;5(6):ofy110
pubmed: 29977965
Infection. 2016 Jun;44(3):395-439
pubmed: 27066980
Clin Infect Dis. 2011 Mar 1;52(5):e103-20
pubmed: 21292654
J Antimicrob Chemother. 2018 Dec 1;73(12):3505-3515
pubmed: 30239728
Infect Dis Clin North Am. 2014 Jun;28(2):247-61
pubmed: 24857391
J Hosp Infect. 2018 Jun;99(2):117-123
pubmed: 28807835
Pediatr Infect Dis J. 2015 Mar;34(3):311-3
pubmed: 25584443
Haematologica. 2013 Dec;98(12):1821-5
pubmed: 24323982
Clin Infect Dis. 2009 Dec 1;49(11):1749-55
pubmed: 19857164
Arch Dis Child Educ Pract Ed. 2017 Aug 9;:
pubmed: 28794004
Clin Infect Dis. 2016 Sep 1;63(5):e61-e111
pubmed: 27418577
J Antimicrob Chemother. 2017 Apr 1;72(4):953-956
pubmed: 27999049
J Infect Chemother. 2019 Sep;25(9):653-656
pubmed: 31182329
Clin Infect Dis. 2014 Oct 15;59 Suppl 3:S97-100
pubmed: 25261548
Infect Control Hosp Epidemiol. 2012 May;33(5):500-6
pubmed: 22476277
Clin Infect Dis. 2007 Jan 15;44(2):159-77
pubmed: 17173212
Curr Pediatr Rev. 2019;15(1):47-52
pubmed: 30657041
Infect Dis Clin North Am. 2014 Jun;28(2):263-79
pubmed: 24857392
Med Mal Infect. 2016 Jun;46(4):200-6
pubmed: 27021932
Clin Infect Dis. 2016 Dec 15;63(12):1639-1644
pubmed: 27682070
Intensive Care Med. 2015 Jul;41(7):1181-96
pubmed: 26077053
Clin Infect Dis. 2016 May 15;62(10):e51-77
pubmed: 27080992
Infect Control Hosp Epidemiol. 2018 Oct;39(10):1237-1245
pubmed: 30227898
J Antimicrob Chemother. 2018 Mar 1;73(suppl_3):iii2-iii78
pubmed: 29514274
Clin Microbiol Infect. 2018 Dec;24(12):1273-1279
pubmed: 30036665
J Antimicrob Chemother. 2019 Oct 1;74(10):3104-3110
pubmed: 31299069
Lancet Infect Dis. 2016 Jul;16(7):847-856
pubmed: 26947617
J Antimicrob Chemother. 2020 Dec 6;75(Supplement_2):ii2-ii19
pubmed: 33280049
J Antimicrob Chemother. 2019 Nov 1;74(11):3384-3389
pubmed: 31361000
Cochrane Database Syst Rev. 2017 Feb 09;2:CD003543
pubmed: 28178770
Pediatr Infect Dis J. 2013 Dec;32(12):e456-65
pubmed: 23958812
Swiss Med Wkly. 2015 Dec 21;145:w14220
pubmed: 26692020
Eur J Clin Microbiol Infect Dis. 2018 Feb;37(2):187-208
pubmed: 28871407
Eur Respir J. 2017 Sep 10;50(3):
pubmed: 28890434
Pharmacotherapy. 2012 Aug;32(8):722-34
pubmed: 23307520
Infect Control Hosp Epidemiol. 2016 Oct;37(10):1195-200
pubmed: 27457099