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Title
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Implementation of a multidisciplinary antimicrobial stewardship programme in a Philippine tertiary care hospital : an evaluation by repeated point prevalence surveys
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Author
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Abstract
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| Objectives: Optimising antimicrobial prescribing in hospitals through antimicrobial stewardship (AMS) is essential in addressing the global threat of antimicrobial resistance. The objective of this study was to evaluate the impact of a hospital-wide programme, delivered by a multidisciplinary AMS team, on antimicrobial prescribing outcomes. Methods: The AMS programme consisted of a combination of persuasive, restrictive, and structural components and was implemented in two phases. We used data from the Global-PPS, collected every six months between September 2017 and December 2019, to measure the antimicrobial use prevalence and monitor selected antibiotic prescribing quality indicators. Results: A significantly increasing trend (p<0.001) was observed for the indicators related to documentation of prescribing, i.e. reason for treatment and stop or review date. We observed a significantly decreasing trend (p<0.001) in the number of prescriptions for surgical antibiotic prophylaxis (SAP) prescribed for more than 24 hours, however, sample sizes for surgical patients were small. For these three indicators, a sudden and pronounced improvement was seen after the second set of interventions, which consisted of (i) an antibiotic documentation policy (ii) a 24h automatic stop order for SAP, and (iii) dissemination of new SAP guidelines. A significantly decreasing trend was also observed for hospital-wide antimicrobial use prevalence (p<0.001). Conclusions: The implementation of a multidisciplinary antimicrobial stewardship programme positively influenced antibiotic prescribing practices. Further research should address long-term trends in antibiotic prescribing to establish whether these coordinated activities have led to a sustained behaviour change amongst prescribers, thereby also evaluating clinical outcomes and antimicrobial resistance rates. |
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Language
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English
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Source (journal)
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Journal of Global Antimicrobial Resistance. - -
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Publication
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2021
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ISSN
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2213-7165
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DOI
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10.1016/J.JGAR.2021.05.009
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Volume/pages
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26
(2021)
, p. 157-165
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ISI
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000696999800031
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Pubmed ID
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34118483
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Full text (Publisher's DOI)
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Full text (open access)
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