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Physician barriers to implementation of hospital-based antimicrobial stewardship programs (ASPs): a global perspective

  • Infection Prevention and Safety in Low and Middle Income Countries (AC Bardossy, Section Editor)
  • Published:
Current Treatment Options in Infectious Diseases Aims and scope Submit manuscript

Abstract

Purpose of review

Antimicrobial resistance (AMR) is a significant global health issue. Hospital-based antimicrobial stewardship programs (ASPs) are an important component of a “One Health” approach for addressing AMR. However, the adaptation and implementation of ASPs in low-resource settings often faces multiple barriers, which need to be identified and addressed to ensure program effectiveness.

Recent findings

Barriers to ASPs adoption have been identified at the health system and hospital levels, within the organization and interpersonal relationships in wards and departments, and at the individual level of knowledge and perceptions of physicians and other health providers regarding AMR and antimicrobial prescribing practices. Utilizing the Consolidated Framework for Implementation Research (CFIR) is one means of providing a model for adapting ASPs to meet local needs and for recognizing and addressing barriers prior to and during program implementation.

Summary

Despite challenges, hospital-based ASPs have been successfully introduced in low-resource settings. Key components of successful ASPs include a focus on de-escalation, development of local prescribing guidelines, inclusion of non-medical training such as communication, and engagement and partnering with a broad coalition of institutional and organizational stakeholders throughout the adaptation, evaluation, implementation, and scale-up processes.

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Authors and Affiliations

  1. Henry Ford Health System, Global Health Initiative, 440 Burroughs Street, Suite 229, Detroit, MI, 48202, USA

    Linda M. Kaljee PhD & Tyler Prentiss

  2. Henry Ford Health System, Division of Infectious Disease, 2799 West Grand Blvd., CFP3, Detroit, MI, 48202, USA

    Marcus Zervos MD

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Kaljee, L.M., Prentiss, T. & Zervos, M. Physician barriers to implementation of hospital-based antimicrobial stewardship programs (ASPs): a global perspective. Curr Treat Options Infect Dis 11, 73–80 (2019). https://doi.org/10.1007/s40506-019-0183-2

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