Deep Dive Into Gaps and Barriers to Implementation of Antimicrobial Stewardship Programs in Hospitals in Latin America.
| Title: | Deep Dive Into Gaps and Barriers to Implementation of Antimicrobial Stewardship Programs in Hospitals in Latin America. |
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| Authors: | Fabre V; Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.; Secaira C; Department of Anthropology and Sociology, Universidad del Valle, Guatemala City, Guatemala.; Cosgrove SE; Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.; Lessa FC; International Infection Control Program, Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.; Patel TS; International Infection Control Program, Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.; Alvarez AA; Unidad de Cirugía Cardiovascular de Guatemala, Guatemala City, Guatemala.; Anchiraico LM; Clínica Universitaria Privada Reina Fabiola, Cordoba, Argentina.; Del Carmen Bangher M; Instituto de Cardiología de Corrientes Juana Francisca Cabral, Corrientes, Argentina.; Barberis MF; Hospital Nacional Profesor Alejandro Posadas, El Palomar, Argentina.; Burokas MS; Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.; Castañeda X; Clínica De La Mujer, Bogota, Colombia.; Colque AM; Hospital Complejo Medico Churruca Visca, Buenos Aires, Argentina.; De Ascencao G; Hospital San Benito, Peten, Guatemala.; Esquivel C; Hospital Alemán, Buenos Aires, Argentina.; Ezcurra C; Hospital Provincial de Rosario, Rosario, Argentina.; Falleroni LA; Hospital San Benito, Peten, Guatemala.; Frassone N; Unidad de Cirugía Cardiovascular de Guatemala, Guatemala City, Guatemala.; Garzón MI; Hospital Privado Universitario de Córdoba, Cordoba, Argentina.; Gomez C; Clínica De La Mujer, Bogota, Colombia.; Hospital Militar Central San José Centro, Bogota, Colombia.; Gonzalez JA; Hospital Irma Lourdes Tzanetatos, Panama, Panamá.; Hernandez D; Hospital Privado Universitario de Córdoba, Cordoba, Argentina.; Laplume D; Hospital Nacional Profesor Alejandro Posadas, El Palomar, Argentina.; Lemir CG; Hospital San Bernardo, Salta, Argentina.; Maldonado Briones H; Unidad de Cirugía Cardiovascular de Guatemala, Guatemala City, Guatemala.; Melgar M; Hospital Roosevelt, Guatemala, Guatemala.; Mesplet F; Hospital Cesar Milstein, Buenos Aires, Argentina.; Martinez G; Hospital San Bernardo, Salta, Argentina.; Pertuz CM; Hospital Del Tunal, Bogota, Colombia.; Moreno C; Hospital Metropolitano, Quito, Ecuador.; Nemirovsky C; Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.; Nuccetelli Y; Instituto de Diagnostico, La Plata, Argentina.; Palacio B; Sanatorio Allende Nueva Córdoba, Cordoba, Argentina.; Sandoval N; Hospital Roosevelt, Guatemala, Guatemala.; Vergara H; Hospital Militar Central San José Centro, Bogota, Colombia.; Videla H; Instituto de Diagnostico, La Plata, Argentina.; Villamandos S; Instituto de Cardiología de Corrientes Juana Francisca Cabral, Corrientes, Argentina.; Villareal O; Hospital Irma Lourdes Tzanetatos, Panama, Panamá.; Viteri A; Hospital Cesar Milstein, Buenos Aires, Argentina.; Quiros R; PROAnet Project Lead and Sanatorio Las Lomas, Buenos Aires, Argentina. |
| Source: | Clinical infectious diseases : an official publication of the Infectious Diseases Society of America [Clin Infect Dis] 2023 Jul 05; Vol. 77 (Suppl 1), pp. S53-S61. |
| Publication Type: | Journal Article; Research Support, Non-U.S. Gov't |
| Language: | English |
| Journal Info: | Publisher: Oxford University Press Country of Publication: United States NLM ID: 9203213 Publication Model: Print Cited Medium: Internet ISSN: 1537-6591 (Electronic) Linking ISSN: 10584838 NLM ISO Abbreviation: Clin Infect Dis Subsets: MEDLINE |
| Imprint Name(s): | Publication: Jan. 2011- : Oxford : Oxford University Press; Original Publication: Chicago, IL : The University of Chicago Press, c1992- |
| MeSH Terms: | Anti-Bacterial Agents*/therapeutic use ; Antimicrobial Stewardship*/methods; Humans ; Latin America ; Hospitals ; Surveys and Questionnaires |
| Abstract: | Background: Antimicrobial resistance has worsened in Latin America. There is an urgent need to understand the development of antimicrobial stewardship programs (ASPs) and the barriers to implementing effective ASPs in light of limited national action plans or policies to promote ASPs in the region.; Methods: We performed a descriptive mixed-methods study of ASPs in 5 Latin American countries in March-July 2022. An electronic questionnaire with an associated scoring system (hospital ASP self-assessment) was used, and ASP development was classified based on the scores (inadequate, 0-25; basic, 26-50; intermediate, 51-75; or advanced, 76-100). Interviews among healthcare workers (HCWs) involved in antimicrobial stewardship (AS) inquired about behavioral and organizational factors that influence AS activities. Interview data were coded into themes. Results from the ASP self-assessment and interviews were integrated to create an explanatory framework.; Results: Twenty hospitals completed the self-assessment, and 46 AS stakeholders from these hospitals were interviewed. ASP development was inadequate/basic in 35% of hospitals, intermediate in 50%, and advanced in 15%. For-profit hospitals had higher scores than not-for-profit hospitals. Interview data validated the self-assessment findings and provided further insight into ASP implementation challenges, which included limited formal hospital leadership support, inadequate staffing and tools to perform AS work more efficiently, limited awareness of AS principles by HCWs, and limited training opportunities.; Conclusions: We identified several barriers to ASP development in Latin America, suggesting the need to create accurate business cases for ASPs to obtain the necessary funding for their effective implementation and sustainability.; (© The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America.) |
| Competing Interests: | Potential conflicts of interest. V. F. reports funding support from CDC including funding to present this work. S. E. C., reports funding support from the CDC. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed. |
| Comments: | Comment in: Clin Infect Dis. 2024 Apr 10;78(4):1073-1075. doi: 10.1093/cid/ciad624.. (PMID: 37816149) |
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| Contributed Indexing: | Keywords: Latin America; antibiotic stewardship |
| Substance Nomenclature: | 0 (Anti-Bacterial Agents) |
| Entry Date(s): | Date Created: 20230705 Date Completed: 20230707 Latest Revision: 20250225 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC10321692 |
| DOI: | 10.1093/cid/ciad184 |
| PMID: | 37406044 |
| Database: | MEDLINE |
Journal Article; Research Support, Non-U.S. Gov't