Antimicrobial stewardship capacity and manpower needs in the Asia Pacific

Tau Hong Lee; David C Lye; Doo Ryeon Chung; Visanu Thamlikitkul; Min Lu; Andrew Ty Wong; Po-Ren Hsueh; Hui Wang; Celia Cooper; Joshua Gx Wong; Nobuyuki Shimono; Van Hung Pham; Jennifer Perera; Yong-Hong Yang; Atef M Shibl; So Hyun Kim; Li Yang Hsu; Jae-Hoon Song

doi:10.1016/j.jgar.2021.01.013

Antimicrobial stewardship capacity and manpower needs in the Asia Pacific

J Glob Antimicrob Resist. 2021 Mar:24:387-394. doi: 10.1016/j.jgar.2021.01.013. Epub 2021 Feb 3.

Authors

Tau Hong Lee¹, David C Lye¹, Doo Ryeon Chung², Visanu Thamlikitkul³, Min Lu⁴, Andrew Ty Wong⁵, Po-Ren Hsueh⁶, Hui Wang⁷, Celia Cooper⁸, Joshua Gx Wong⁹, Nobuyuki Shimono¹⁰, Van Hung Pham¹¹, Jennifer Perera¹², Yong-Hong Yang¹³, Atef M Shibl¹⁴, So Hyun Kim², Li Yang Hsu¹⁵, Jae-Hoon Song¹⁶

Affiliations

¹ Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore; Department of Infectious Diseases, National Centre for Infectious Diseases, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
² Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asia Pacific Foundation for Infectious Diseases, Seoul, Republic of Korea.
³ Faculty of Medicine Siriraj Hospital, Thailand.
⁴ Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China.
⁵ Infectious Disease Control Training Centre, Hospital Authority, Hong Kong.
⁶ Departments of Laboratory Medicine and Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
⁷ Department of Clinical Laboratory, Peking University People's Hospital, Beijing, China.
⁸ Department of Infectious Diseases, Women's and Children's Hospital, South Australia, Australia.
⁹ Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore.
¹⁰ Center for the Study of Global Infection, Kyushu University Hospital, Japan.
¹¹ School of Medicine, University of Medicine and Pharmacy, Ho Chi Minh City, Viet Nam.
¹² Department of Microbiology, Faculty of Medicine, University of Colombo, Sri Lanka.
¹³ Beijing Children's Hospital, Capital Medical University, Beijing, China.
¹⁴ Department of Microbiology and Immunology, College of Medicine, Al-Faisal University, Riyadh, Saudi Arabia.
¹⁵ Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore; Department of Infectious Diseases, National Centre for Infectious Diseases, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
¹⁶ Asia Pacific Foundation for Infectious Diseases, Seoul, Republic of Korea; CHA Bio Group, Gyeonggi-do, Republic of Korea.

PMID: 33548495
DOI: 10.1016/j.jgar.2021.01.013

Abstract

Objectives: Antimicrobial stewardship is a strategy to combat antimicrobial resistance in hospitals. Given the burden and impact of antimicrobial resistance in the Asia Pacific, it is important to document capacity and gaps in antimicrobial stewardship programmes (ASP). We aimed to understand existing capacities and practices, and define the resources needed to establish antimicrobial stewardship where it is lacking.

Methods: An anonymous online survey, consisting of questions on antimicrobial control at country, hospital and programme levels, was circulated to healthcare providers in the field of infectious diseases and microbiology through Asian Network for Surveillance of Resistant Pathogens, ReAct Group and the Australasian Society for infectious Diseases.

Results: 139 participants from 16 countries or regions completed the survey. The majority of participants were adult infectious diseases physicians (61/139, 43.9%) and microbiologists (31/139, 22.3%). Participants from 7 countries reported that antimicrobials can be obtained without prescriptions. Despite the high percentage (75.5%) of respondents working in large hospitals, only 22/139 participants (15.8%) from Australia, China, Singapore, Taiwan, Thailand and Vietnam reported having more than 10 infectious diseases physicians. Hospital empiric antimicrobial guidelines for common infections were available according to 110/139 (79.1%) participants. Pre-authorisation of antimicrobials was reported by 88/113 (77.9%) respondents while prospective audit and feedback was reported by 93/114 (81.6%). Automatic stop orders and culture-guided de-escalation were reported by only 52/113 (46.0%) and 27/112 (24.1%) respectively.

Conclusion: The survey reveals a wide range of ASP development in Asia Pacific. Establishing national workgroups and guidelines will help advance antimicrobial stewardship in this diverse region.

Keywords: Antimicrobial stewardship; Asia Pacific; Capacity; Manpower, survey.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Antimicrobial Stewardship*
Australia
China
Humans
Singapore
Taiwan
Thailand
Vietnam
Workforce