Abstract
Objective: The aim of this study was to assess antimicrobial stewardship activities in Community Healthcare Organisations (CHOs) with focus on the implementation of the two national antimicrobial stewardship toolkits, TARGET (Treat Antibiotics Responsibly, Guidance, Education, Tools) and SSTF (Start Smart, then Focus). The study utilised a web-based survey comprising 34 questions concerning antimicrobial policies and awareness and implementation of antimicrobial stewardship toolkits. This was distributed to pharmacy teams in all 26 CHOs in England. Twenty CHOs (77%) responded. An antimicrobial stewardship (AMS) committee was active in 50% of CHOs; 25% employed a substantive pharmacist post and 70% had a local antibiotic policy. Fourteen of the responding CHOs were aware of both AMS toolkits, five organisations were aware of either SSTF or TARGET, and one organisation was not aware of either toolkit. Of the organisations aware of SSTF and TARGET, eight had formally reviewed both toolkits, though three had not reviewed either. Less than half of the respondents had developed local action plans for either toolkit. National guidance in England has focused attention on initiatives to improve AMS implementation in primary and secondary care; more work is required to embed AMS activities and the implementation of national AMS toolkit recommendations within CHOs.
Highlights
Antimicrobial resistance (AMR) poses a serious threat to global public health with clinical and economic implications
Twenty Community Healthcare Organisations (CHOs) (77%) out of the 26 CHOs in England responded to the survey; there were responsible for managing 93 hospitals overall and serving a total population of nearly 28 million
Need to complete mandatory e-learning module. The findings of this survey showed a variable implementation of the national antimicrobial stewardship (AMS) toolkits in community healthcare organisations
Summary
Antimicrobial resistance (AMR) poses a serious threat to global public health with clinical and economic implications. Antibiotic-resistant bacterial infections are associated with increased mortality compared to those without resistance [1]. The overuse and inappropriate use of antimicrobials is recognised as the major driver for the development of AMR [2]. Antimicrobial stewardship (AMS) programmes encourage the responsible use of antimicrobials through the delivery of multiple evidence-based interventions. Studies demonstrate that AMS interventions reduce excessive antibiotic prescribing in secondary care, can reduce AMR and healthcare. Antibiotics 2018, 7, 97 associated infections (HCAIs), increase effective prescribing, and improve clinical outcomes for patients [3]. AMS programmes are increasingly regarded as essential to tackling AMR and safeguarding human health [4,5]
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