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International Journal of Clinical Pharmacy

, Volume 37, Issue 5, pp 776–781 | Cite as

Antimicrobial stewardship activities in hospitals in Ireland and the United Kingdom: a comparison of two national surveys

  • Aoife FlemingEmail author
  • Antonella Tonna
  • Síle O’Connor
  • Stephen Byrne
  • Derek Stewart
Research Article

Abstract

Background Best practice guidelines recommend that a multidisciplinary Antimicrobial Management Team (AMT) conduct antimicrobial stewardship (AMS) activities in hospitals. In order to continuously improve AMS activities in Irish hospitals it is important to benchmark performance by comparison with other countries. Objective To compare the membership of AMTs and AMS activities conducted in Irish and United Kingdom (UK) hospitals. Methods A postal questionnaire to determine the membership and activities of AMTs was issued to the specialist antimicrobial pharmacist or pharmacist in charge at all Irish Hospitals and all UK National Health Service Hospitals. The membership of AMTs and the extent of AMS activities conducted were compared between the countries. Results The response rates to the surveys were 73 % (n = 51) in Ireland and 33 % in the UK (n = 273). 57 % of Irish respondents reported having an AMT compared to 82 % in the UK (p < 0.001). Significantly more AMTs in the UK had a specialist antimicrobial pharmacist on the team (95 % UK, 69 % Ireland, p < 0.001). A higher proportion of Irish respondents reported measuring the overall volume of antimicrobial prescribing (Ireland 85 %, UK 72 %, p = 0.057). A higher proportion of UK respondents reported measuring the appropriateness of antimicrobial prescribing (76 % UK, 58 % Ireland, p = 0.019) and the appropriateness of restricted antimicrobial prescribing (64 % UK, 52 % Ireland, p = 0.140). Conclusion Irish and UK AMTs need to be supported to recruit and retain specialist antimicrobial pharmacists and to achieve higher rates of audit, prescription appropriateness review and feedback activities.

Keywords

Antibiotics Antibiotic prescribing Antimicrobial stewardship Hospital pharmacy Ireland Survey United Kingdom 

Notes

Acknowledgments

The authoring team would like to acknowledge the participation of all respondents to the survey.

Funding

The first author is funded by the Health Research Board in Ireland under the Scholars Programme in Health Services Research Grant No. PHD/2007/16.

Conflicts of interest

There are no conflicts of interest to declare.

References

  1. 1.
    SARI Hospital Antimicrobial Stewardship Working Group. Guidelines for antimicrobial stewardship in hospitals in Ireland. Health Service Executive, Health Protection Surveillance Centre; 2009. Report no. 978-0-9551236-7-2.Google Scholar
  2. 2.
    American Society of Health System Pharmacists. ASHP statement on the pharmacist’s role in antimicrobial stewardship and infection prevention and control. Am J Health Syst Pharm Off J Am Soc Health Syst Pharm. 2010;67(7):575–7.Google Scholar
  3. 3.
    Drew RH. Antimicrobial stewardship programs: how to start and steer a successful program. J Manag Care Pharm. 2009;15(2 Suppl):S18–23.PubMedGoogle Scholar
  4. 4.
    Wickens HJ, Farrell S, Ashiru-Oredope DA, Jacklin A, Holmes A. The increasing role of pharmacists in antimicrobial stewardship in English hospitals. J Antimicrob Chemother. 2013;68(11):2675–81.CrossRefPubMedGoogle Scholar
  5. 5.
    Department of Health. UK Five year Antimicrobial Resistance Strategy 2013 to 2018. London; 2013. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/238872/20130902_UK_5_year_AMR_strategy_FINAL.pdf. 9 Oct 2014.
  6. 6.
    Society for Healthcare Epidemiology of America (SHEA), the Infectious Diseases Society of America (IDSA), the Pediatric Infectious Diseases Society (PIDS). Policy statement on antimicrobial stewardship. Infect Control Hosp Epidemiol. 2012;33(4):322–7.CrossRefGoogle Scholar
  7. 7.
    Fleming A, Tonna A, O’Connor S, Byrne S, Stewart D. A cross-sectional survey of the profile and activities of Antimicrobial Management Teams in Irish Hospitals. Int J Clin Pharm. 2014;36(2):377–83.CrossRefPubMedGoogle Scholar
  8. 8.
    Tonna AP, Gould IM, Stewart D. A cross-sectional survey of antimicrobial stewardship strategies in UK hospitals. J Clin Pharm Ther. 2014;39(5):516–20.CrossRefPubMedGoogle Scholar
  9. 9.
    Health Information and Quality Authority. National standards for the prevention and control of healthcare associated infection; 2009. http://www.hiqa.ie/system/files/National_Standards_Prevention_Control_Infections.pdf. 9 Oct 2014.
  10. 10.
    Department of Health’s Advisory Committee on Antimicrobial Resistance and Healthcare Associated Infection (ARHAI). Antimicrobial Stewardship: “Start Smart - then Focus”; 2011. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/215308/dh_131181.pdf. 9 Oct 2014.
  11. 11.
    MacDougall C, Polk RE. Antimicrobial stewardship programs in health care systems. Clin Microbiol Rev. 2005;18(4):638–56.PubMedCentralCrossRefPubMedGoogle Scholar
  12. 12.
    Health Protection Surveillance Centre. Hospital Antimicrobial Consumption Surveillance. Ireland: HPSC; 2014. http://www.hpsc.ie/A-Z/MicrobiologyAntimicrobialResistance/EuropeanSurveillanceofAntimicrobialConsumptionESAC/PublicMicroB/SACHC/Report1.html. 3 Dec 2014.
  13. 13.
    Public Health England. English surveillance programme for antimicrobial utilisation and resistance (ESPAUR). London; 2014. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/362374/ESPAUR_Report_2014__3_pdf. 9 Oct 2014.
  14. 14.
    Patient First UK. MicroGuide no. 1 Healthcare app in the UK. United Kingdom: Patient First; 2014. http://www.patientfirstuk.com/Press/MicroGuide-No1-Mobile-Healthcare-App-in-the-UK. 3 Dec 2014.

Copyright information

© Koninklijke Nederlandse Maatschappij ter bevordering der Pharmacie 2015

Authors and Affiliations

  • Aoife Fleming
    • 1
    Email author
  • Antonella Tonna
    • 2
  • Síle O’Connor
    • 3
  • Stephen Byrne
    • 1
  • Derek Stewart
    • 2
  1. 1.Pharmaceutical Care Research Group, School of PharmacyUniversity College CorkCorkIreland
  2. 2.School of Pharmacy and Life SciencesRobert Gordon UniversityAberdeenScotland, UK
  3. 3.Pharmacy DepartmentBon Secours HospitalTralee, County KerryIreland

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