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CP-139 A cross-sectional survey of antimicrobial stewardship strategies in UK hospitals
  1. AP Tonna1,
  2. IM Gould2,
  3. D Stewart3
  1. 1Robert Gordon University, School of Pharmacy and Life Sciences, Aberdeen, UK
  2. 2Medical Microbiology, Aberdeen Royal Infirmary, Aberdeen, UK
  3. 3School of Pharmacy and Life Sciences, Robert Gordon University, Aberdeen, UK

Abstract

Background To improve prescribing and reduce antimicrobial resistance, antimicrobial stewardship programmes have been implemented in hospitals, usually led by antimicrobial management teams (AMTs). Many of these teams include a hospital pharmacist.

Purpose The objective of this study was to describe the profile and activities of AMTs within hospitals in the United Kingdom (UK).

Materials and methods All hospitals within the UK (n = 836) were included and a pre-piloted questionnaire was mailed to the ‘Director of Pharmacy.’ Non-respondents were mailed up to two reminder questionnaires at two weekly intervals. Results were analysed using SPSS and Minitabs.

Main outcome measures Existence and remit of the AMTs; availability of antimicrobial prescribing policies, aims, scope and methods of dissemination; monitoring and feedback provided on antimicrobial policy adherence.

Results Response rate 33% (n = 273)

Completed questionnaires analysed n = 226 (n = 47 incomplete – reasons given include no pharmacy department, already completed by another site)

Responses were largely from English hospitals (70%); district general hospitals (57%). 82 (n = 186) of respondents indicated the presence of an AMT within the hospital, with 95% of these (n = 177) reporting an antimicrobial pharmacist as part of the team.

All AMTs (n = 186) were involved in development of an antimicrobial policy and almost all (99% n = 184) promoted adherence and restricted use of specific antimicrobials (97% n = 180).

98% of respondents (n = 222) reported the availability of a local antimicrobial prescribing policy within the hospital with this disseminated mainly through the hospital intranet (98% n = 217). Adherence to policy was measured mainly through audits measuring the appropriateness of antimicrobial use against the local policy (76% n = 169).

Hospitals in England (p = 0.010), tertiary care hospitals (p = 0.021) and bed capacity >1500 (p < 0.001) were more likely to have an AMT. Audits to measure policy adherence were more likely (p < 0.001) if an AMT was present. Nurses (89% n = 201) and pharmacists (73% n = 165) were most likely to be involved in National Medicines Policies (NMP) of antimicrobials.

Conclusions While most respondents reported an antimicrobial prescribing policy, fewer had an AMT. Despite recent government and regional initiatives, further improvements in antimicrobial stewardship are still required.

No conflict of interest.

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