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      Antimicrobial Stewardship Programs in Florida's Acute Care Facilities

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          Abstract

          We surveyed acute care facilities in Florida to assess components of and barriers to sustained antimicrobial stewardship programs (ASPs). Most respondents with and without ASPs are doing some stewardship-related activities to improve antimicrobial use. Collaborative efforts between facilities and health departments are important to providing better resources for ASPs.

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          Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America guidelines for developing an institutional program to enhance antimicrobial stewardship.

          Timothy H Dellit, Robert Owens, John E. McGowan … (2007)
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            "Collateral damage" from cephalosporin or quinolone antibiotic therapy.

            David L. Paterson (2004)
            "Collateral damage" is a term used to refer to ecological adverse effects of antibiotic therapy; namely, the selection of drug-resistant organisms and the unwanted development of colonization or infection with multidrug-resistant organisms. The risk of such damage can be assessed for different antibiotic classes by a variety of epidemiologic studies. Cephalosporin use has been linked to subsequent infection with vancomycin-resistant enterococci, extended-spectrum beta-lactamase-producing Klebsiella pneumoniae, beta-lactam-resistant Acinetobacter species, and Clostridium difficile. Quinolone use has been linked to infection with methicillin-resistant Staphylococcus aureus and with increasing quinolone resistance in gram-negative bacilli, such as Pseudomonas aeruginosa. Neither third-generation cephalosporins nor quinolones appear suitable for sustained use in hospitals as "workhorse" antibiotic therapy.
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              Improving antimicrobial stewardship: the evolution of programmatic strategies and barriers.

              Susan E Beekmann, Ramanan Laxminarayan, Arjun Srinivasan … (2011)
              To describe the prevalence and characteristics of antimicrobial stewardship programs (ASPs) in hospitals across the United States and to describe financial support provided for these programs. Electronic and paper 14-question survey of infectious diseases physician members of the Infectious Diseases Society of America Emerging Infections Network (IDSA EIN). All 1,044 IDSA EIN members who care for adult patients were invited to participate. Five hundred twenty-two (50%) members responded. Seventy-three percent of respondents reported that their institutions had or were planning an ASP, compared with 50% reporting the same thing in an EIN survey 10 years before. A shift was noted from formulary restriction alone to use of a set of tailored strategies designed to provide information and feedback to prescribers, particularly in community hospitals. Lack of funding and lack of personnel were reported as major barriers to implementing a program. Fifty-two percent of respondents with an ASP reported that infectious diseases physicians do not receive direct compensation for their participation in the ASP, compared with 18% 10 years ago. The percentage of institutions reporting ASPs has increased over the last decade, although small community hospitals were least likely to have these programs. In addition, ASP strategies have shifted dramatically. Lack of funding remains a key barrier for ASPs, and administrators need additional cost savings data in order to support ASPs. Interestingly, while guidelines and editorials regard compensated participation by an infectious diseases physician in these programs as critical, we found that more than half of the respondents reported no direct compensation for ASP activities.
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                Author and article information

                Journal
                Journal ID (publisher-id): applab
                Title: Infection Control & Hospital Epidemiology
                Abbreviated Title: Infect Control Hosp Epidemiol
                Publisher: University of Chicago Press
                ISSN (Print): 0899-823X
                ISSN (Electronic): 1559-6834
                Publication date Created: June 2013
                Publication date (Print): January 2 2015
                Volume: 34
                Issue: 06
                Pages: 634-637
                Article
                DOI: 10.1086/670632
                SO-VID: 389d2304-5aaa-4721-86b1-1709b49be35b
                Copyright © © 2015
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