Quality, availability and suitability of antimicrobial stewardship guidance: a multinational qualitative study.


Journal

JAC-antimicrobial resistance
ISSN: 2632-1823
Titre abrégé: JAC Antimicrob Resist
Pays: England
ID NLM: 101765283

Informations de publication

Date de publication:
Apr 2024
Historique:
received: 07 12 2023
accepted: 19 02 2024
medline: 15 3 2024
pubmed: 15 3 2024
entrez: 15 3 2024
Statut: epublish

Résumé

Antimicrobial stewardship (AMS) programmes are established across the world to treat infections efficiently, prioritize patient safety, and reduce the emergence of antimicrobial resistance. One of the core elements of AMS programmes is guidance to support and direct physicians in making efficient, safe and optimal decisions when prescribing antibiotics. To optimize and tailor AMS, we need a better understanding of prescribing physicians' experience with AMS guidance. To explore the prescribing physicians' user experience, needs and targeted improvements of AMS guidance in hospital settings. Semi-structured interviews were conducted with 36 prescribing physicians/AMS guidance users from hospital settings in Canada, Germany, Israel, Latvia, Norway and Sweden as a part of the international PILGRIM trial. A socioecological model was applied as an overarching conceptual framework for the study. Research participants were seeking more AMS guidance than is currently available to them. The most important aspects and targets for improvement of AMS guidance were: (i) quality of guidelines; (ii) availability of infectious diseases specialists; and (iii) suitability of AMS guidance to department context. Achieving prudent antibiotic use not only depends on individual and collective levels of commitment to follow AMS guidance but also on the quality, availability and suitability of the guidance itself. More substantial commitment from stakeholders is needed to allocate the required resources for delivering high-quality, available and relevant AMS guidance to make sure that the prescribers' AMS needs are met.

Sections du résumé

Background UNASSIGNED
Antimicrobial stewardship (AMS) programmes are established across the world to treat infections efficiently, prioritize patient safety, and reduce the emergence of antimicrobial resistance. One of the core elements of AMS programmes is guidance to support and direct physicians in making efficient, safe and optimal decisions when prescribing antibiotics. To optimize and tailor AMS, we need a better understanding of prescribing physicians' experience with AMS guidance.
Objectives UNASSIGNED
To explore the prescribing physicians' user experience, needs and targeted improvements of AMS guidance in hospital settings.
Methods UNASSIGNED
Semi-structured interviews were conducted with 36 prescribing physicians/AMS guidance users from hospital settings in Canada, Germany, Israel, Latvia, Norway and Sweden as a part of the international PILGRIM trial. A socioecological model was applied as an overarching conceptual framework for the study.
Results UNASSIGNED
Research participants were seeking more AMS guidance than is currently available to them. The most important aspects and targets for improvement of AMS guidance were: (i) quality of guidelines; (ii) availability of infectious diseases specialists; and (iii) suitability of AMS guidance to department context.
Conclusions UNASSIGNED
Achieving prudent antibiotic use not only depends on individual and collective levels of commitment to follow AMS guidance but also on the quality, availability and suitability of the guidance itself. More substantial commitment from stakeholders is needed to allocate the required resources for delivering high-quality, available and relevant AMS guidance to make sure that the prescribers' AMS needs are met.

Identifiants

pubmed: 38486662
doi: 10.1093/jacamr/dlae039
pii: dlae039
pmc: PMC10939443
doi:

Types de publication

Journal Article

Langues

eng

Pagination

dlae039

Investigateurs

Pauls Aldins (P)
Viesturs Zvirbulis (V)
Christian Kjellander (C)
Anne Mette Asfeldt (AM)
Hannes Wåhlin (H)
Per Espen Akselsen (PE)
Merve Kaya (M)
Lucas J Fein (LJ)
Lena M Biehl (LM)
Thilo Dietz (T)
Kerstin Albus (K)
Nick Schulze (N)
Fedja Farowski (F)
Nadine Conzelmann (N)
Simone Eisenbeis (S)
Leonard Leibovici (L)
Maayan Huberman Samuel (MH)
Elina Langusa (E)
Jelena Urbena (J)
Barbara Ann Jardin (BA)
Lylie Mbuyi (L)
Frida Karlsson (F)
Toni Myrbakk (T)
Marte Tangeraas Hansen (MT)
Tina Fure Torkehagen (TF)
Silje Severine Sætre (SS)
Anita Helene Jarodd (AH)
Sissel Frostad Oftedal (SF)
Anne Dalheim (A)
Franziska Ebeling (F)
Nina Angelstein (N)
Susanna Proske (S)
Gabriel Sauer (G)
Christian Blumberg (C)
Alina Rüb (A)
Sarina Butzer (S)
Markus Quante (M)
Maximilian Christopeit (M)
Silvia Wagner (S)
Vered Daitch (V)
Yulia Maler Yaron (YM)
Tanya Babich (T)

Informations de copyright

© The Author(s) 2024. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy.

Auteurs

Zane Linde-Ozola (Z)

Faculty of Medicine, University of Latvia, Riga, Latvia.

Annika Y Classen (AY)

Faculty of Medicine, University of Cologne, Cologne, Germany.
Department I for Internal Medicine, University Hospital Cologne, Cologne, Germany.
German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany.

Christian G Giske (CG)

Department of Laboratory Medicine, Karolinska Institute, Stockholm, Sweden.
Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden.

Siri Göpel (S)

Department of Internal Medicine I, Division of infectious diseases, University Hospital Tübingen, Tübingen, Germany.
Clinical Research Unit for Healthcare Associated and Antibiotic Resistant Bacterial Infections, German Centre for Infection Research (DZIF), Tübingen, Germany.

Noa Eliakim-Raz (N)

Internal Medicine E, Rabin Medical Center Beilinson Campus, Petah-Tikva, Israel.
Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Makeda Semret (M)

Infectious Diseases and Medical Microbiology, McGill University Health Centre, Montreal, Canada.

Gunnar Skov Simonsen (GS)

Department of Microbiology and Infection Control, University Hospital of North Norway, Tromsø, Norway.
UiT-The Arctic University of Norway, Tromsø, Norway.

Jörg Janne Vehreschild (JJ)

Faculty of Medicine, University of Cologne, Cologne, Germany.
Department I for Internal Medicine, University Hospital Cologne, Cologne, Germany.
German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany.
Department II of Internal Medicine, Haematology/Oncology, Goethe University Frankfurt, Frankfurt am Main, Germany.

Silje Bakken Jørgensen (SB)

Department of Medical Microbiology and Infection Control and Department of Emergency Care, Akershus University Hospital, Lørenskog, Norway.

Johanna Kessel (J)

Department of Internal Medicine, Infectious Diseases, Goethe University Frankfurt, Frankfurt Am Main, Germany.

Lars Kåre Selland Kleppe (LKS)

Department of Infection Prevention and Control, Stavanger University Hospital, Stavanger, Norway.

Dorthea Hagen Oma (DH)

Section for Patient Safety, Haukeland University Hospital, Bergen, Norway.

Maria J G T Vehreschild (MJGT)

Faculty of Medicine, University of Cologne, Cologne, Germany.
Department I for Internal Medicine, University Hospital Cologne, Cologne, Germany.
German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany.
Department of Internal Medicine, Infectious Diseases, Goethe University Frankfurt, Frankfurt Am Main, Germany.

Aija Vilde (A)

Faculty of Medicine, University of Latvia, Riga, Latvia.
Pauls Stradins Clinical University Hospital, Riga, Latvia.

Uga Dumpis (U)

Faculty of Medicine, University of Latvia, Riga, Latvia.
Pauls Stradins Clinical University Hospital, Riga, Latvia.

Classifications MeSH