A Survey of Antimicrobial Stewardship Program among Hospitals in the 6th Health Region of Thailand
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Abstract
Objective: To survey strategies, barriers and measurement of outcomes of implementing an Antimicrobial Stewardship Program (ASP) among hospitals in the sixth Health Region. Method: This survey research was conducted among pharmacists in 124 public and private hospitals within the sixth Health Region. The study used a questionnaire to collect data on the implementation of ASP in terms of strategies, barriers and monitoring and evaluation. The study was conducted during November 30, 2020 to December 31, 2020. Results: The subjects in 41 hospitals responded to the survey (33.1 percent response rate). All hospitals implemented ASP with 3 or more strategies. The most common strategy was prospective audit and feedback (97.4%), followed by formulary restriction and antibiotic authorization (86.8%). The most common barriers in ASP implementation were heavy workload and non-compliance with criteria or requirements. 93.6% of the hospitals participating in the study used indicators of antimicrobial use in the unit of defined daily dose. Conclusion: Most hospitals in the sixth Health Region showed an appropriate ASP implementation. All implemented three or more strategies. From the barriers identified in the study, team responsible for the ASP should clearly define the criteria for the implementation of the strategies.
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ผลการวิจัยและความคิดเห็นที่ปรากฏในบทความถือเป็นความคิดเห็นและอยู่ในความรับผิดชอบของผู้นิพนธ์ มิใช่ความเห็นหรือความรับผิดชอบของกองบรรณาธิการ หรือคณะเภสัชศาสตร์ มหาวิทยาลัยสงขลานครินทร์ ทั้งนี้ไม่รวมความผิดพลาดอันเกิดจากการพิมพ์ บทความที่ได้รับการเผยแพร่โดยวารสารเภสัชกรรมไทยถือเป็นสิทธิ์ของวารสารฯ
References
Sumpradit N, Suttajit S, Poonpholsap S, Chuanchuen R. Landscape of antimicrobial resistance situation and action in Thailand. Bangkok: Aksorn Graphic and Design Publishing; 2014.
National Antimicrobial Resistance Surveillance Center Antimicrobial resistance 2000-2019 [online]. 2019 [cited May 8, 2020]. Available from: narst.dmsc.mo ph.go.th/data/AMR%202000-2019-06M.pdf
Yingkhajorn S, Sutthichot S, Hongthong N, Boonrod T, Simla W, Sriraksa S. Occurrence of antimicrobial resistance in hospital: A systematic review and meta-analysis. Journal of Health Science 2021; 30: 916-27.
Ministry of Health, Ministry of Agriculture and Coope- ratives. Strategic plan for antimicrobial resistance management in Thailand 2017-2021 [online]. 2017 [cited May 10, 2020]. Available from: narst.dmsc.m oph.go.th/documentation.html.
Centers for Disease Control and Prevention. The core elements of hospital antibiotic stewardship programs [online]. 2019 [cited May 9, 2020]. Availa ble from: www.cdc.gov/antibiotic-use/core-elements /hospital.html.
World Health Organization. Global action plan on antimicrobial resistance [online]. 2016 [cited Apr 19, 2020]. Available from: www.who.int/publications /i/item/9789241509763.
Barlam TF, Cosgrove SE, Abbo LM, MacDougall C, Schuetz AN, Septimus EJ, et al. Implementing an antibiotic stewardship program: Guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America. Clin Infect Dis 2016; 62: e51-77.
Suttajit S, Sumpradit N, Hunnangkul S, Prakongsai P, Thamlikitkul V. Hospital Infection Control and Antimicrobial Stewardship Programs among Public and Private Hospitals in Thailand. Journal of Health System Research 2013; 7: 281-95.
Office of Inspector General, Ministry of Public Health. Comprehensive Ministry of Public Health inspection report round 1, fiscal year 2019 [online]. 2019 [Cited Oct 23, 2020]. Available from: data.ptho.mop h.go.th/inspec/2562/inspec62_2/.
World Health Organization. Antimicrobial Steward ship Programmes in health-care facilities in low-and middle-income countries [online]. 2019 [cited Apr 19, 2020]. Available from: apps.who.int/iris/discove r?&query=antimicrobial%20stewardship.
Dellit TH, Owens RC, McGowan JE, Jr., Gerding DN, Weinstein RA, Burke JP, et al. Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America guidelines for developing an institutional program to enhance antimicrobial stewardship. Clin Infect Dis 2007; 44: 159-77.
Moehring RW, Anderson DJ, Cochran RL, Hicks LA, Srinivasan A, Dodds Ashley ES. Expert consensus on metrics to assess the impact of patient-level antimicrobial stewardship interventions in acute-care settings. Clin Infect Dis 2017; 64: 377-83.
Rattanaumpawan P. Antimicrobial stewardship in hospitals. Bangkok: Faculty of Medicine Siriraj Hospital; 2018.
Anon. ASHP statement on the pharmacist's role in antimicrobial stewardship and infection prevention and control. Am J Health Syst Pharm 2010; 67: 575-7.
Ananwattanakit M, Usayaporn S, Tantawichien T, Puttilerpong C, Pengsuparp T. Effects of pharma cist participation in an antimicrobial stewardship program on appropriate antibiotic use. Thai Pharma ceutical and Health Science Journal 2015; 10: 1-9.
