TY - JOUR
T1 - Hospital-based Antimicrobial Stewardship in Denmark, Greenland, and the Faroe Islands - Current landscape and barriers
AU - Kraef, Christian
AU - Öbrink-Hansen, Kristina
AU - Hertz, Mathias
AU - Hagen, Trine Langfeldt
AU - Deutch, Susanna
AU - Holler, Jon Gitz
AU - Olesen, Birthe Riis
AU - Holm, Mette
AU - Gaini, Shahin
AU - Koch, Anders
AU - Benfield, Thomas
AU - Rosenvinge, Flemming S
AU - Johansen, Isik Somuncu
N1 - Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.
PY - 2024/4
Y1 - 2024/4
N2 - OBJECTIVES: To describe the current organization and implementation of formalized, multidisciplinary 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 multidisciplinary structure and a multidisciplinary 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 multidisciplinary hospital-based AMS can be strengthened in Danish hospitals. Funding, clear mandates, prioritization from the hospital management, and the implementation of multidisciplinary AMS-structures may help close the identified gaps.
AB - OBJECTIVES: To describe the current organization and implementation of formalized, multidisciplinary 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 multidisciplinary structure and a multidisciplinary 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 multidisciplinary hospital-based AMS can be strengthened in Danish hospitals. Funding, clear mandates, prioritization from the hospital management, and the implementation of multidisciplinary AMS-structures may help close the identified gaps.
KW - Antimicrobial resistance
KW - Antimicrobial stewardship
KW - Denmark
KW - Faroe Islands
KW - Greenland
KW - Hospital
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
SN - 0195-6701
VL - 146
SP - 66
EP - 75
JO - The Journal of hospital infection
JF - The Journal of hospital infection
ER -