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Antimicrobial stewardship for acute-care hospitals: An Asian perspective

Published online by Cambridge University Press:  19 September 2018

Anucha Apisarnthanarak ,
Andrea Lay-Hoon Kwa ,
Cheng-Hsun Chiu ,
Suresh Kumar ,
Le Thi Anh Thu ,
Ban Hock Tan ,
Zhiyong Zong ,
Yin Ching Chuang ,
Anis Karuniawati  and
Maria Fe Tayzon
...Show all authors
Anucha Apisarnthanarak*
Affiliation:
Division of Infectious Diseases, Faculty of Medicine, Thammasat University Hospital, Pathumthani, Thailand
Andrea Lay-Hoon Kwa
Affiliation:
Department of Pharmacy, Singapore General Hospital, Singapore Emerging Infectious Diseases, Duke-National University of Singapore Medical School, Singapore Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore
Cheng-Hsun Chiu
Affiliation:
Department of Pediatrics, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan
Suresh Kumar
Affiliation:
Department of Medicine, Hospital Sungai Buloh, Sungai Buloh, Malaysia
Le Thi Anh Thu
Affiliation:
Department of Infection Control, Cho Ray Hospital, Ho Chi Minh City, Vietnam
Ban Hock Tan
Affiliation:
Department Infectious Diseases, Singapore General Hospital, Singapore
Zhiyong Zong
Affiliation:
Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, China
Yin Ching Chuang
Affiliation:
Department of Internal Medicine, Chi Mei Medical Center, Liouying, Taiwan, Taiwan Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan
Anis Karuniawati
Affiliation:
Department of Microbiology, Faculty of Medicine, Universitas Indonesia Cipto Mangunkusumo Hospital, Jakarta, Indonesia
Maria Fe Tayzon
Affiliation:
Hospital Infection Control and Epidemiology Center, The Medical City, Pasig City, Philippines Ateneo School of Medicine and Public Health, Manila, Philippines
Thomas Man-Kit So
Affiliation:
Infectious disease specialist in private practice, Hong Kong
Lance R. Peterson
Affiliation:
NorthShore University Health System, Evanston, Illinois, United States University of Chicago Pritzker School of Medicine, Chicago, Illinois, United States.
*
Author for correspondence: Anucha Apisarnthanarak, Division of Infectious Diseases, Faculty of Medicine, Thammasat University Hospital, Pathumthani, Thailand 12120. E-mail: anapisarn@yahoo.com
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Abstract

Inappropriate use of antibiotics is contributing to a serious antimicrobial resistance problem in Asian hospitals. Despite resource constraints in the region, all Asian hospitals should implement antimicrobial stewardship (AMS) programs to optimize antibiotic treatment, improve patient outcomes, and minimize antimicrobial resistance. This document describes a consensus statement from a panel of regional experts to help multidisciplinary AMS teams design programs that suit the needs and resources of their hospitals. In general, AMS teams must decide on appropriate interventions (eg, prospective audit and/or formulary restriction) for their hospital, focusing on the most misused antibiotics and problematic multidrug-resistant organisms. This focus is likely to include carbapenem use with the goal to reduce carbapenem-resistant gram-negative bacteria. Rather than initially trying to introduce a comprehensive, hospital-wide AMS program, it would be practical to begin by pilot testing a simple program based on 1 achievable core intervention for the hospital. AMS team members must work together to determine the most suitable AMS interventions to implement in their hospitals and how best to put them into practice. Continuous monitoring and feedback of outcomes to the AMS teams, hospital administration, and prescribers will enhance sustainability of the AMS programs.

Type
Review
Information
Infection Control & Hospital Epidemiology , Volume 39 , Issue 10 , October 2018 , pp. 1237 - 1245
Copyright
© 2018 by The Society for Healthcare Epidemiology of America. All rights reserved 

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