Hospital-based antimicrobial stewardship in Denmark, Greenland and the Faroe Islands – current landscape and barriers

C. Kraef; K. Öbrink-Hansen; M. Hertz; T. L. Hagen; S. Deutch; J. G. Holler; B. R. Olesen; M. Holm; S. Gaini; A. Koch; T. Benfield; F. S. Rosenvinge; I. S. Johansen

doi:10.1016/j.jhin.2024.01.018

Hospital-based antimicrobial stewardship in Denmark, Greenland and the Faroe Islands – current landscape and barriers

C. Kraef^*, K. Öbrink-Hansen, M. Hertz, T. L. Hagen, S. Deutch, J. G. Holler, B. R. Olesen, M. Holm, S. Gaini, A. Koch, T. Benfield, F. S. Rosenvinge, I. S. Johansen

^*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review

Abstract

Objectives: To describe the current organization and implementation of formalized, multi-disciplinary hospital-based antimicrobial stewardship (AMS) structures in Denmark, the Faroe Islands and Greenland. Methods: A structured electronic questionnaire was sent to all trainees and specialists in clinical microbiology (N=207) and infectious diseases (N=260), as well as clinical pharmacists (N=20) and paediatricians (N=10) with expertise in infectious diseases. The survey had 30 multiple-choice, rating-scale, and open-ended questions based on an international consensus checklist for hospital AMS, adapted to a Danish context. Results: Overall, 145 individual responses representing 20 hospitals were received. Nine hospitals (45%) reported a formal AMS strategy, eight (40%) a formal organizational multi-disciplinary structure and a multi-disciplinary AMS team, and six (30%) a designated professional as a leader of the AMS team. A majority of hospitals reported access to updated guidelines (80%) and regularly monitored and reported the quantity of antibiotics prescribed (70% and 65%, respectively). Only one hospital (5%) reported a dedicated, sustainable and sufficient AMS budget, three hospitals (15%) audited courses of therapy for specific agents/clinical conditions and four hospitals (20%) had a document clearly defining roles, procedures of collaboration and responsibilities for AMS. A total of 42% of all individual respondents had received formal AMS training. Main barriers were a lack of financial resources (52%), a lack of mandate from the hospital management (30%) and AMS not being a priority (18%). Conclusions: Core elements important for multi-disciplinary hospital-based AMS can be strengthened in Danish hospitals. Funding, clear mandates, prioritization from the hospital management and the implementation of multi-disciplinary AMS structures may help close the identified gaps.

Originalsprog	Engelsk
Tidsskrift	Journal of Hospital Infection
Vol/bind	146
Sider (fra-til)	66-75
Antal sider	10
ISSN	0195-6701
DOI	https://doi.org/10.1016/j.jhin.2024.01.018
Status	Udgivet - apr. 2024

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10.1016/j.jhin.2024.01.018Licens: CC BY

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Kraef, C., Öbrink-Hansen, K., Hertz, M., Hagen, T. L., Deutch, S., Holler, J. G., Olesen, B. R., Holm, M., Gaini, S., Koch, A., Benfield, T., Rosenvinge, F. S., & Johansen, I. S. (2024). Hospital-based antimicrobial stewardship in Denmark, Greenland and the Faroe Islands – current landscape and barriers. Journal of Hospital Infection, 146, 66-75. https://doi.org/10.1016/j.jhin.2024.01.018

@article{42341981f7f6487d82543f0bfc22d083,

title = "Hospital-based antimicrobial stewardship in Denmark, Greenland and the Faroe Islands – current landscape and barriers",

abstract = "Objectives: To describe the current organization and implementation of formalized, multi-disciplinary hospital-based antimicrobial stewardship (AMS) structures in Denmark, the Faroe Islands and Greenland. Methods: A structured electronic questionnaire was sent to all trainees and specialists in clinical microbiology (N=207) and infectious diseases (N=260), as well as clinical pharmacists (N=20) and paediatricians (N=10) with expertise in infectious diseases. The survey had 30 multiple-choice, rating-scale, and open-ended questions based on an international consensus checklist for hospital AMS, adapted to a Danish context. Results: Overall, 145 individual responses representing 20 hospitals were received. Nine hospitals (45%) reported a formal AMS strategy, eight (40%) a formal organizational multi-disciplinary structure and a multi-disciplinary AMS team, and six (30%) a designated professional as a leader of the AMS team. A majority of hospitals reported access to updated guidelines (80%) and regularly monitored and reported the quantity of antibiotics prescribed (70% and 65%, respectively). Only one hospital (5%) reported a dedicated, sustainable and sufficient AMS budget, three hospitals (15%) audited courses of therapy for specific agents/clinical conditions and four hospitals (20%) had a document clearly defining roles, procedures of collaboration and responsibilities for AMS. A total of 42% of all individual respondents had received formal AMS training. Main barriers were a lack of financial resources (52%), a lack of mandate from the hospital management (30%) and AMS not being a priority (18%). Conclusions: Core elements important for multi-disciplinary hospital-based AMS can be strengthened in Danish hospitals. Funding, clear mandates, prioritization from the hospital management and the implementation of multi-disciplinary AMS structures may help close the identified gaps.",

keywords = "Antimicrobial resistance, Antimicrobial stewardship, Denmark, Faroe Islands, Greenland, Hospital, Hospitals, Antimicrobial Stewardship, Humans, Communicable Diseases",

author = "C. Kraef and K. {\"O}brink-Hansen and M. Hertz and Hagen, {T. L.} and S. Deutch and Holler, {J. G.} and Olesen, {B. R.} and M. Holm and S. Gaini and A. Koch and T. Benfield and Rosenvinge, {F. S.} and Johansen, {I. S.}",

note = "Publisher Copyright: {\textcopyright} 2024 The Author(s)",

year = "2024",

month = apr,

doi = "10.1016/j.jhin.2024.01.018",

language = "English",

volume = "146",

pages = "66--75",

journal = "Journal of Hospital Infection",

issn = "0195-6701",

publisher = "W.B. Saunders Ltd",

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Kraef, C, Öbrink-Hansen, K, Hertz, M, Hagen, TL, Deutch, S, Holler, JG, Olesen, BR, Holm, M, Gaini, S, Koch, A, Benfield, T, Rosenvinge, FS & Johansen, IS 2024, 'Hospital-based antimicrobial stewardship in Denmark, Greenland and the Faroe Islands – current landscape and barriers', Journal of Hospital Infection, bind 146, s. 66-75. https://doi.org/10.1016/j.jhin.2024.01.018

TY - JOUR

T1 - Hospital-based antimicrobial stewardship in Denmark, Greenland and the Faroe Islands – current landscape and barriers

AU - Kraef, C.

AU - Öbrink-Hansen, K.

AU - Hertz, M.

AU - Hagen, T. L.

AU - Deutch, S.

AU - Holler, J. G.

AU - Olesen, B. R.

AU - Holm, M.

AU - Gaini, S.

AU - Koch, A.

AU - Benfield, T.

AU - Rosenvinge, F. S.

AU - Johansen, I. S.

PY - 2024/4

Y1 - 2024/4

N2 - Objectives: To describe the current organization and implementation of formalized, multi-disciplinary hospital-based antimicrobial stewardship (AMS) structures in Denmark, the Faroe Islands and Greenland. Methods: A structured electronic questionnaire was sent to all trainees and specialists in clinical microbiology (N=207) and infectious diseases (N=260), as well as clinical pharmacists (N=20) and paediatricians (N=10) with expertise in infectious diseases. The survey had 30 multiple-choice, rating-scale, and open-ended questions based on an international consensus checklist for hospital AMS, adapted to a Danish context. Results: Overall, 145 individual responses representing 20 hospitals were received. Nine hospitals (45%) reported a formal AMS strategy, eight (40%) a formal organizational multi-disciplinary structure and a multi-disciplinary AMS team, and six (30%) a designated professional as a leader of the AMS team. A majority of hospitals reported access to updated guidelines (80%) and regularly monitored and reported the quantity of antibiotics prescribed (70% and 65%, respectively). Only one hospital (5%) reported a dedicated, sustainable and sufficient AMS budget, three hospitals (15%) audited courses of therapy for specific agents/clinical conditions and four hospitals (20%) had a document clearly defining roles, procedures of collaboration and responsibilities for AMS. A total of 42% of all individual respondents had received formal AMS training. Main barriers were a lack of financial resources (52%), a lack of mandate from the hospital management (30%) and AMS not being a priority (18%). Conclusions: Core elements important for multi-disciplinary hospital-based AMS can be strengthened in Danish hospitals. Funding, clear mandates, prioritization from the hospital management and the implementation of multi-disciplinary AMS structures may help close the identified gaps.

AB - Objectives: To describe the current organization and implementation of formalized, multi-disciplinary hospital-based antimicrobial stewardship (AMS) structures in Denmark, the Faroe Islands and Greenland. Methods: A structured electronic questionnaire was sent to all trainees and specialists in clinical microbiology (N=207) and infectious diseases (N=260), as well as clinical pharmacists (N=20) and paediatricians (N=10) with expertise in infectious diseases. The survey had 30 multiple-choice, rating-scale, and open-ended questions based on an international consensus checklist for hospital AMS, adapted to a Danish context. Results: Overall, 145 individual responses representing 20 hospitals were received. Nine hospitals (45%) reported a formal AMS strategy, eight (40%) a formal organizational multi-disciplinary structure and a multi-disciplinary AMS team, and six (30%) a designated professional as a leader of the AMS team. A majority of hospitals reported access to updated guidelines (80%) and regularly monitored and reported the quantity of antibiotics prescribed (70% and 65%, respectively). Only one hospital (5%) reported a dedicated, sustainable and sufficient AMS budget, three hospitals (15%) audited courses of therapy for specific agents/clinical conditions and four hospitals (20%) had a document clearly defining roles, procedures of collaboration and responsibilities for AMS. A total of 42% of all individual respondents had received formal AMS training. Main barriers were a lack of financial resources (52%), a lack of mandate from the hospital management (30%) and AMS not being a priority (18%). Conclusions: Core elements important for multi-disciplinary hospital-based AMS can be strengthened in Danish hospitals. Funding, clear mandates, prioritization from the hospital management and the implementation of multi-disciplinary AMS structures may help close the identified gaps.

KW - Antimicrobial resistance

KW - Antimicrobial stewardship

KW - Denmark

KW - Faroe Islands

KW - Greenland

KW - Hospital

KW - Hospitals

KW - Antimicrobial Stewardship

KW - Humans

KW - Communicable Diseases

UR - http://www.scopus.com/inward/record.url?scp=85186480743&partnerID=8YFLogxK

U2 - 10.1016/j.jhin.2024.01.018

DO - 10.1016/j.jhin.2024.01.018

M3 - Journal article

C2 - 38354955

AN - SCOPUS:85186480743

SN - 0195-6701

VL - 146

SP - 66

EP - 75

JO - Journal of Hospital Infection

JF - Journal of Hospital Infection

ER -

Hospital-based antimicrobial stewardship in Denmark, Greenland and the Faroe Islands – current landscape and barriers

Abstract

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