Abstract
BACKGROUND: Antimicrobial Stewardship Programs (ASPs) have been promoted to optimize antimicrobial usage and patient outcomes, and to reduce the emergence of antimicrobial-resistant organisms. However, the best strategies for an ASP are not definitively established and are likely to vary based on local culture, policy, and routine clinical practice, and probably limited resources in middle-income countries. The aim of this study is to evaluate structures and resources of antimicrobial stewardship teams (ASTs) in surgical departments from different regions of the world.
METHODS: A cross-sectional web-based survey was conducted in 2016 on 173 physicians who participated in the AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections) project and on 658 international experts in the fields of ASPs, infection control, and infections in surgery.
RESULTS: The response rate was 19.4%. One hundred fifty-six (98.7%) participants stated their hospital had a multidisciplinary AST. The median number of physicians working inside the team was five [interquartile range 4-6]. An infectious disease specialist, a microbiologist and an infection control specialist were, respectively, present in 80.1, 76.3, and 67.9% of the ASTs. A surgeon was a component in 59.0% of cases and was significantly more likely to be present in university hospitals (89.5%, p < 0.05) compared to community teaching (83.3%) and community hospitals (66.7%). Protocols for pre-operative prophylaxis and for antimicrobial treatment of surgical infections were respectively implemented in 96.2 and 82.3% of the hospitals. The majority of the surgical departments implemented both persuasive and restrictive interventions (72.8%). The most common types of interventions in surgical departments were dissemination of educational materials (62.5%), expert approval (61.0%), audit and feedback (55.1%), educational outreach (53.7%), and compulsory order forms (51.5%).
CONCLUSION: The survey showed a heterogeneous organization of ASPs worldwide, demonstrating the necessity of a multidisciplinary and collaborative approach in the battle against antimicrobial resistance in surgical infections, and the importance of educational efforts towards this goal.
| Original language | English |
|---|---|
| Pages (from-to) | 34 |
| Journal | World journal of emergency surgery : WJES |
| Volume | 12 |
| DOIs | |
| Publication status | Published - 2017 |
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The Global Alliance for Infections in Surgery : defining a model for antimicrobial stewardship-results from an international cross-sectional survey. / Sartelli, Massimo; Labricciosa, Francesco M; Barbadoro, Pamela; Pagani, Leonardo; Ansaloni, Luca; Brink, Adrian J; Carlet, Jean; Khanna, Ashish; Chichom-Mefire, Alain; Coccolini, Federico; Di Saverio, Salomone; May, Addison K; Viale, Pierluigi; Watkins, Richard R; Scudeller, Luigia; Abbo, Lilian M; Abu-Zidan, Fikri M; Adesunkanmi, Abdulrashid K; Al-Dahir, Sara; Al-Hasan, Majdi N; Alis, Halil; Alves, Carlos; Araujo da Silva, André R; Augustin, Goran; Bala, Miklosh; Barie, Philip S; Beltrán, Marcelo A; Bhangu, Aneel; Bouchra, Belefquih; Brecher, Stephen M; Caínzos, Miguel A; Camacho-Ortiz, Adrian; Catani, Marco; Chandy, Sujith J; Jusoh, Asri Che; Cherry-Bukowiec, Jill R; Chiara, Osvaldo; Colak, Elif; Cornely, Oliver A; Cui, Yunfeng; Demetrashvili, Zaza; De Simone, Belinda; De Waele, Jan J; Dhingra, Sameer; Di Marzo, Francesco; Dogjani, Agron; Dorj, Gereltuya; Dortet, Laurent; Duane, Therese M; Elmangory, Mutasim M; Enani, Mushira A; Ferrada, Paula; Esteban Foianini, J; Gachabayov, Mahir; Gandhi, Chinmay; Ghnnam, Wagih Mommtaz; Giamarellou, Helen; Gkiokas, Georgios; Gomi, Harumi; Goranovic, Tatjana; Griffiths, Ewen A; Guerra Gronerth, Rosio I; Haidamus Monteiro, Julio C; Hardcastle, Timothy C; Hecker, Andreas; Hodonou, Adrien M; Ioannidis, Orestis; Isik, Arda; Iskandar, Katia A; Kafil, Hossein S; Kanj, Souha S; Kaplan, Lewis J; Kapoor, Garima; Karamarkovic, Aleksandar R; Kenig, Jakub; Kerschaever, Ivan; Khamis, Faryal; Khokha, Vladimir; Kiguba, Ronald; Kim, Hong B; Ko, Wen-Chien; Koike, Kaoru; Kozlovska, Iryna; Kumar, Anand; Lagunes, Leonel; Latifi, Rifat; Lee, Jae G; Lee, Young R; Leppäniemi, Ari; Li, Yousheng; Liang, Stephen Y; Lowman, Warren; Machain, Gustavo M; Maegele, Marc; Major, Piotr; Malama, Sydney; Manzano-Nunez, Ramiro; Marinis, Athanasios; Martinez Casas, Isidro; Marwah, Sanjay; Maseda, Emilio; McFarlane, Michael E; Memish, Ziad; Mertz, Dominik; Mesina, Cristian; Mishra, Shyam K; Moore, Ernest E; Munyika, Akutu; Mylonakis, Eleftherios; Napolitano, Lena; Negoi, Ionut; Nestorovic, Milica D; Nicolau, David P; Omari, Abdelkarim H; Ordonez, Carlos A; Paiva, José-Artur; Pant, Narayan D; Parreira, Jose G; Pędziwiatr, Michal; Pereira, Bruno M; Ponce-de-Leon, Alfredo; Poulakou, Garyphallia; Preller, Jacobus; Pulcini, Céline; Pupelis, Guntars; Quiodettis, Martha; Rawson, Timothy M; Reis, Tarcisio; Rems, Miran; Rizoli, Sandro; Roberts, Jason; Pereira, Nuno Rocha; Rodríguez-Baño, Jesús; Sakakushev, Boris; Sanders, James; Santos, Natalia; Sato, Norio; Sawyer, Robert G; Scarpelini, Sandro; Scoccia, Loredana; Shafiq, Nusrat; Shelat, Vishalkumar; Sifri, Costi D; Siribumrungwong, Boonying; Søreide, Kjetil; Soto, Rodolfo; de Souza, Hamilton P; Talving, Peep; Trung, Ngo Tat; Tessier, Jeffrey M; Tumbarello, Mario; Ulrych, Jan; Uranues, Selman; Van Goor, Harry; Vereczkei, Andras; Wagenlehner, Florian; Xiao, Yonghong; Yuan, Kuo-Ching; Wechsler-Fördös, Agnes; Zahar, Jean-Ralph; Zakrison, Tanya L; Zuckerbraun, Brian; Zuidema, Wietse P; Catena, Fausto.
In: World journal of emergency surgery : WJES, Vol. 12, 2017, p. 34.Research output: Contribution to journal › Article › Academic › peer-review
TY - JOUR
T1 - The Global Alliance for Infections in Surgery
T2 - defining a model for antimicrobial stewardship-results from an international cross-sectional survey
AU - Sartelli, Massimo
AU - Labricciosa, Francesco M
AU - Barbadoro, Pamela
AU - Pagani, Leonardo
AU - Ansaloni, Luca
AU - Brink, Adrian J
AU - Carlet, Jean
AU - Khanna, Ashish
AU - Chichom-Mefire, Alain
AU - Coccolini, Federico
AU - Di Saverio, Salomone
AU - May, Addison K
AU - Viale, Pierluigi
AU - Watkins, Richard R
AU - Scudeller, Luigia
AU - Abbo, Lilian M
AU - Abu-Zidan, Fikri M
AU - Adesunkanmi, Abdulrashid K
AU - Al-Dahir, Sara
AU - Al-Hasan, Majdi N
AU - Alis, Halil
AU - Alves, Carlos
AU - Araujo da Silva, André R
AU - Augustin, Goran
AU - Bala, Miklosh
AU - Barie, Philip S
AU - Beltrán, Marcelo A
AU - Bhangu, Aneel
AU - Bouchra, Belefquih
AU - Brecher, Stephen M
AU - Caínzos, Miguel A
AU - Camacho-Ortiz, Adrian
AU - Catani, Marco
AU - Chandy, Sujith J
AU - Jusoh, Asri Che
AU - Cherry-Bukowiec, Jill R
AU - Chiara, Osvaldo
AU - Colak, Elif
AU - Cornely, Oliver A
AU - Cui, Yunfeng
AU - Demetrashvili, Zaza
AU - De Simone, Belinda
AU - De Waele, Jan J
AU - Dhingra, Sameer
AU - Di Marzo, Francesco
AU - Dogjani, Agron
AU - Dorj, Gereltuya
AU - Dortet, Laurent
AU - Duane, Therese M
AU - Elmangory, Mutasim M
AU - Enani, Mushira A
AU - Ferrada, Paula
AU - Esteban Foianini, J
AU - Gachabayov, Mahir
AU - Gandhi, Chinmay
AU - Ghnnam, Wagih Mommtaz
AU - Giamarellou, Helen
AU - Gkiokas, Georgios
AU - Gomi, Harumi
AU - Goranovic, Tatjana
AU - Griffiths, Ewen A
AU - Guerra Gronerth, Rosio I
AU - Haidamus Monteiro, Julio C
AU - Hardcastle, Timothy C
AU - Hecker, Andreas
AU - Hodonou, Adrien M
AU - Ioannidis, Orestis
AU - Isik, Arda
AU - Iskandar, Katia A
AU - Kafil, Hossein S
AU - Kanj, Souha S
AU - Kaplan, Lewis J
AU - Kapoor, Garima
AU - Karamarkovic, Aleksandar R
AU - Kenig, Jakub
AU - Kerschaever, Ivan
AU - Khamis, Faryal
AU - Khokha, Vladimir
AU - Kiguba, Ronald
AU - Kim, Hong B
AU - Ko, Wen-Chien
AU - Koike, Kaoru
AU - Kozlovska, Iryna
AU - Kumar, Anand
AU - Lagunes, Leonel
AU - Latifi, Rifat
AU - Lee, Jae G
AU - Lee, Young R
AU - Leppäniemi, Ari
AU - Li, Yousheng
AU - Liang, Stephen Y
AU - Lowman, Warren
AU - Machain, Gustavo M
AU - Maegele, Marc
AU - Major, Piotr
AU - Malama, Sydney
AU - Manzano-Nunez, Ramiro
AU - Marinis, Athanasios
AU - Martinez Casas, Isidro
AU - Marwah, Sanjay
AU - Maseda, Emilio
AU - McFarlane, Michael E
AU - Memish, Ziad
AU - Mertz, Dominik
AU - Mesina, Cristian
AU - Mishra, Shyam K
AU - Moore, Ernest E
AU - Munyika, Akutu
AU - Mylonakis, Eleftherios
AU - Napolitano, Lena
AU - Negoi, Ionut
AU - Nestorovic, Milica D
AU - Nicolau, David P
AU - Omari, Abdelkarim H
AU - Ordonez, Carlos A
AU - Paiva, José-Artur
AU - Pant, Narayan D
AU - Parreira, Jose G
AU - Pędziwiatr, Michal
AU - Pereira, Bruno M
AU - Ponce-de-Leon, Alfredo
AU - Poulakou, Garyphallia
AU - Preller, Jacobus
AU - Pulcini, Céline
AU - Pupelis, Guntars
AU - Quiodettis, Martha
AU - Rawson, Timothy M
AU - Reis, Tarcisio
AU - Rems, Miran
AU - Rizoli, Sandro
AU - Roberts, Jason
AU - Pereira, Nuno Rocha
AU - Rodríguez-Baño, Jesús
AU - Sakakushev, Boris
AU - Sanders, James
AU - Santos, Natalia
AU - Sato, Norio
AU - Sawyer, Robert G
AU - Scarpelini, Sandro
AU - Scoccia, Loredana
AU - Shafiq, Nusrat
AU - Shelat, Vishalkumar
AU - Sifri, Costi D
AU - Siribumrungwong, Boonying
AU - Søreide, Kjetil
AU - Soto, Rodolfo
AU - de Souza, Hamilton P
AU - Talving, Peep
AU - Trung, Ngo Tat
AU - Tessier, Jeffrey M
AU - Tumbarello, Mario
AU - Ulrych, Jan
AU - Uranues, Selman
AU - Van Goor, Harry
AU - Vereczkei, Andras
AU - Wagenlehner, Florian
AU - Xiao, Yonghong
AU - Yuan, Kuo-Ching
AU - Wechsler-Fördös, Agnes
AU - Zahar, Jean-Ralph
AU - Zakrison, Tanya L
AU - Zuckerbraun, Brian
AU - Zuidema, Wietse P
AU - Catena, Fausto
PY - 2017
Y1 - 2017
N2 - BACKGROUND: Antimicrobial Stewardship Programs (ASPs) have been promoted to optimize antimicrobial usage and patient outcomes, and to reduce the emergence of antimicrobial-resistant organisms. However, the best strategies for an ASP are not definitively established and are likely to vary based on local culture, policy, and routine clinical practice, and probably limited resources in middle-income countries. The aim of this study is to evaluate structures and resources of antimicrobial stewardship teams (ASTs) in surgical departments from different regions of the world.METHODS: A cross-sectional web-based survey was conducted in 2016 on 173 physicians who participated in the AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections) project and on 658 international experts in the fields of ASPs, infection control, and infections in surgery.RESULTS: The response rate was 19.4%. One hundred fifty-six (98.7%) participants stated their hospital had a multidisciplinary AST. The median number of physicians working inside the team was five [interquartile range 4-6]. An infectious disease specialist, a microbiologist and an infection control specialist were, respectively, present in 80.1, 76.3, and 67.9% of the ASTs. A surgeon was a component in 59.0% of cases and was significantly more likely to be present in university hospitals (89.5%, p < 0.05) compared to community teaching (83.3%) and community hospitals (66.7%). Protocols for pre-operative prophylaxis and for antimicrobial treatment of surgical infections were respectively implemented in 96.2 and 82.3% of the hospitals. The majority of the surgical departments implemented both persuasive and restrictive interventions (72.8%). The most common types of interventions in surgical departments were dissemination of educational materials (62.5%), expert approval (61.0%), audit and feedback (55.1%), educational outreach (53.7%), and compulsory order forms (51.5%).CONCLUSION: The survey showed a heterogeneous organization of ASPs worldwide, demonstrating the necessity of a multidisciplinary and collaborative approach in the battle against antimicrobial resistance in surgical infections, and the importance of educational efforts towards this goal.
AB - BACKGROUND: Antimicrobial Stewardship Programs (ASPs) have been promoted to optimize antimicrobial usage and patient outcomes, and to reduce the emergence of antimicrobial-resistant organisms. However, the best strategies for an ASP are not definitively established and are likely to vary based on local culture, policy, and routine clinical practice, and probably limited resources in middle-income countries. The aim of this study is to evaluate structures and resources of antimicrobial stewardship teams (ASTs) in surgical departments from different regions of the world.METHODS: A cross-sectional web-based survey was conducted in 2016 on 173 physicians who participated in the AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections) project and on 658 international experts in the fields of ASPs, infection control, and infections in surgery.RESULTS: The response rate was 19.4%. One hundred fifty-six (98.7%) participants stated their hospital had a multidisciplinary AST. The median number of physicians working inside the team was five [interquartile range 4-6]. An infectious disease specialist, a microbiologist and an infection control specialist were, respectively, present in 80.1, 76.3, and 67.9% of the ASTs. A surgeon was a component in 59.0% of cases and was significantly more likely to be present in university hospitals (89.5%, p < 0.05) compared to community teaching (83.3%) and community hospitals (66.7%). Protocols for pre-operative prophylaxis and for antimicrobial treatment of surgical infections were respectively implemented in 96.2 and 82.3% of the hospitals. The majority of the surgical departments implemented both persuasive and restrictive interventions (72.8%). The most common types of interventions in surgical departments were dissemination of educational materials (62.5%), expert approval (61.0%), audit and feedback (55.1%), educational outreach (53.7%), and compulsory order forms (51.5%).CONCLUSION: The survey showed a heterogeneous organization of ASPs worldwide, demonstrating the necessity of a multidisciplinary and collaborative approach in the battle against antimicrobial resistance in surgical infections, and the importance of educational efforts towards this goal.
KW - Journal Article
U2 - 10.1186/s13017-017-0145-2
DO - 10.1186/s13017-017-0145-2
M3 - Article
C2 - 28775763
VL - 12
SP - 34
JO - World journal of emergency surgery : WJES
JF - World journal of emergency surgery : WJES
SN - 1749-7922
ER -