Antibiotic stewardship programmes: national recommendations, public release of structure and process indicator and practical implementation in south-western French hospitals, 20052008
Abstract number: P1494
Dumartin C., Rogues A.M., Pefau M., Amadeo B., Venier A.G., Parneix P., Maurain C.
Objectives: According to the national strategy launched in 2001 to improve antibiotic (AB) use, French hospitals are required to implement AB stewardship programmes (ABS). The Ministry of Health (MoH) issued recommendations regarding AB monitoring, organisation for prudent use (2006), and enforced mandatory reporting of a structure and process indicator (SPI) reflecting ABS, intented for public disclosure (2007). We performed yearly surveys to describe the development of hospital ABS in Southwestern France and to assess the compliance with national requirements.
Methods: Annual retrospective surveys were conducted in a convenience sample of 84 hospitals (22% of hospital beds in the region): 24 secondary/tertiary public hospitals, 31 acute care private hospitals, 14 rehabilitation centres, 8 local and 7 psychiatric hospitals. ABS was assessed by questions on structure and organisation; resources, guidelines, surveillance and evaluation. We described each measure, the SPI and their evolution for each hospital from 2005 to 2008.
Results: Improvements were seen in the content of ABS for each type of hospitals. SPI values were higher for private hospitals and rehabilitation centres than in others. In 2008, at least 98% of hospitals had implemented formularies, antibiotic committees, AB prophylaxis guidelines, and monitored AB use. AB advisors were appointed in 85% of hospitals in 2008 compared to 50% in 2005. Areas covered by official texts and included in SPI sharply improved from 2006: treatment guidelines (2006), computerised tools for AB management (2006), AB monitoring (2007), evaluation (2007). Little progress was made regarding time dedicated by pharmacist to AB management and restricted dispensation of AB using stop-orders.
Conclusion: Official texts and the public disclosure of a SPI have increased professionals and hospital managers' commitment to develop ABS, and resulted in improvements in most hospitals. However, even in hospitals involved in voluntary surveys, some measures still need to be reinforced, e.g. computerized tools for AB management, evaluation. It also appears crucial to consider practical implementation of regulatory required measures, as it will impact on their effectiveness: time spent by professionals, type of restrictive dispensation system, real use of evaluation and surveillance data, adaptation to hospital resources and needs.
|Session name:||Abstracts 20th European Congress of Clinical Microbiology and Infectious Diseases|
|Location:||Vienna, Austria, 10 - 13 April 2010|
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