Antimicrobial Stewardship Programmes in Brazil: introductory analysis

Abstract

Introduction: Antimicrobial Stewardship Program (ASP) aims to reeducate the use of antimicrobials. Objective: To manage and evaluate the implementation of ASP in an Adult Intensive Care Unit in Brazilian hospitals. Method: Prospective cross-sectional study, reporting introductory data and factors that advised and helped to implement the ASP in 954 (55.6%) hospitals, corresponding to 25,565 beds, from all 27 Brazilian states.Results: Of the 954 hospitals, 453 (47.5%) have ASP, with the most regular factors being: 369 (81.5%) top management support; 343 (75.7%) availability of clinical protocols; 276 (60.9%) support and adherence by doctors and 259 (57.2%) official definition of the management team. The most difficult causes were: 202 (44.6%) operational team without defined or insufficient time; 134 (29.6%) lack of information technology support; 173 (38.2%) resistance or opposition from doctors and 116 (25.6%) lack of commitment from the teams. Conclusion: the implementation of ASP is an executable proposal for the optimization and rational use in the management of antimicrobials. In Brazil, this proposal will collaborate for direct actions in ICUs, guided by the government, with a relevant impact on the control of antimicrobial resistance. In Brazil, this proposal will contribute to direct actions in ICUs, guided by the government, with a relevant impact on the control of antimicrobial resistance. Brazil needs to improve all elements, with education and definition of responsibilities and professionals.