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Majority of hospitals have antimicrobial stewardship policies
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New data suggest 64% of hospitals currently have an antimicrobial stewardship policy in place, and hospitals in California were more likely to have a policy compared with hospitals in other states.
“Given the higher prevalence of antimicrobial stewardship policies in our California sample than in the rest of the country, it seems that the statutory requirement played a role in the initiation of antimicrobial stewardship policies,” the researchers wrote in Infection Control and Hospital Epidemiology. “These results also confirm the finding that many California hospitals were able to meet the statutory requirements with the institution of policies and perhaps without specifically instituting a formal [antimicrobial stewardship program].”
Researchers from Thomas Jefferson University in Philadelphia, the University of Iowa and Columbia University conducted a cross-sectional survey of infection control directors from hospitals that participate in the National Healthcare Safety Network (NHSN). The online survey was conducted in the fall of 2011. A subset of the hospitals also provided their 2011 NHSN survey data.
They received responses from 1,015 hospitals, for a 30% response rate. Among those, 64% reported having an antimicrobial stewardship policy. The most frequently reported activities included hospital- or unit-based antibiograms, antimicrobial restriction for certain agents and automatic stop orders. About one-third of hospitals reported requiring consults with infectious disease or microbiology before prescribing antimicrobials and/or prescriber audit and feedback.
Seventy-five hospitals in California, the only state that mandates acute care hospitals to have an antimicrobial policy, were included in the survey. Compared with other states, more California hospitals reported having an antimicrobial stewardship policy: 77% vs. 63% (P = .014). California hospitals were more likely to require specified indications for the prescribed antimicrobials compared with other states: 36% vs. 21% (P = .009).
Hospital characteristics associated with having a policy included larger, urban teaching hospitals, hospitals that take part in a health care-associated infection initiative and hospitals that are part of a larger system that shares infection prevention resources.
“Statewide efforts in California seem to be having their intended effect of increasing the implementation of policies,” the researchers wrote. “Further research is needed to strengthen the evidence base on the effectiveness of these policies and to identify factors that foster their adoption.” – by Emily Shafer
Disclosure: The researchers report no relevant financial disclosures.
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