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Antimicrobial stewardship program sees results in Israeli hospitals
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Public health officials in Israel say a nationwide antimicrobial stewardship program has shown pronounced reduction of antibiotic use in the hospital setting during the first 4 years, but has had a smaller impact on outpatient use.
Mitchell J. Schwaber, MD, MSc, of the National Center for Infection Control in the Israel Ministry of Health (MOH), reported nationwide surveillance data of antibiotic use between 2012 and 2015 during a presentation today at the Society for Healthcare Epidemiology of America (SHEA) spring conference in St. Louis.
Government regulations put in place in 2012 require general hospitals, post-acute care hospitals, and the outpatient care sector of HMOs in Israel to establish antimicrobial stewardship programs, develop treatment guidelines and methods to control prescribing, and file annual reports on antibiotic consumption to the MOH. According to Schwaber and colleagues, 98% of the hospitals and HMOs reported compliance with the regulations by the fourth year of surveillance.
“Future plans include surveillance of use by indication, centralized guidelines for institutional stewardship programs, training staff to conduct such programs and coordination with the Ministry of Agriculture to deepen oversight of antibiotic use in the agricultural sector,” Schwaber told Infectious Disease News.
The researchers calculated antibiotic consumption in the hospitals as defined daily doses (DDD) per 100 patient-days for hospitals and DDD per 1,000 insured patients per day for HMOs.
In general hospitals, comparisons were reported from the ICU, general surgery and general medicine wards. Use declined in all three — by 7% in ICUs, 11% in general surgery wards, and 8% in internal medicine wards, according to the researchers.
In post-acute care hospitals, where Schwaber and colleagues said there had been little oversight before the new regulations, a 32% reduction in antibiotic use was observed. However, there was little observed decline in the community — around 4% — despite ranking in the top third in outpatient antibiotic consumption when compared with European countries.
“Four years since implementation of a national requirement for [antimicrobial stewardship programs] at health care institutions, Israel has established uniform, comprehensive surveillance of antimicrobial use in all human health care sectors,” Schwaber and colleagues concluded. “The reporting requirement and annual feedback provided by the MOH have led to a reduction in use in acute and long-term care hospitals nationwide but little effect as yet in the outpatient setting." – by Gerard Gallagher
Reference:
Temkin E, et al. Comprehensive surveillance of human antibiotic use in Israel, 2012-2015. Presented at: Society for Healthcare Epidemiology of America (SHEA) spring conference; March 29-31, 2017; St. Louis.
Disclosure : The researchers report no relevant financial disclosures.