Snapshot of Antimicrobial Stewardship in Australian Hospitals

Abstract

ABSTRACTBackgroundThe diminishing investment into the development of new antimicrobials is of significant global concern. This, coupled with the emergence of anti‐infective drug resistance, highlights the need to both prolong and optimise the use of existing antimicrobials. Strategies or programs to optimise antimicrobial use fall under the broad heading of antimicrobial stewardship.AimTo identify the types of antimicrobial stewardship programs in existence in Australian hospitals and their perceived success.MethodDirectors of Pharmacy or their nominees (n = 281) working in Australian hospitals were surveyed to identify their institutional antimicrobial stewardship programs. Infectious disease clinicians, infection control nurses and hospital pharmacists were recruited for the qualitative interviews. They were interviewed until saturation of themes was identified. All of the interviews were transcribed verbatim and analysed for common themes.ResultsResponses were received from 80 Directors of Pharmacy or their nominees (29% response rate). The types of antimicrobial stewardship programs identified can be broadly grouped into: administration‐related; antimicrobial use and prescribing‐related; education and training‐related; and infection control and surveillance‐related. A variety of strategies are used to promote appropriate prescribing of antimicrobials, resulting in varying levels of perceived success, for example the use of Drug and Therapeutics Committees, formulary restrictions, locally developed antimicrobial guidelines and streamlining or de‐escalation of therapy. Clinical leadership, a multidisciplinary approach and the availability of enthusiastic and motivated individuals are critical to the success of antimicrobial stewardship programs.ConclusionAustralian hospitals have implemented a variety of antimicrobial stewardship programs with varying degrees of perceived success.