Prioritizing research areas for antibiotic stewardship programmes in hospitals: a behavioural perspective consensus paper

• DOI: 10.1016/j.cmi.2018.08.020
• Publication Date: 2018-09-07T08:01:53Z
• Authors: M. Rzewuska; E. Charani; J.E. Clarkson; P.G. Davey; E.M. Duncan; J.J. Francis; K. Gillies; W.V. Kern; F. Lorencatto; C.A. Marwick; J. McEwen; R. Möhler; A.M. Morris; C.R. Ramsay; S. Rogers Van Katwyk; B. Skodvin; I. Smith; K.N. Suh; J.M. Grimshaw
• Keywords: Antibiotic Stewardship; Stewardship; Antimicrobial Stewardship; Consensus conference

<h2>Abstract</h2><h3>Scope</h3> Antibiotic stewardship programmes (ASPs) are necessary in hospitals to improve the judicious use of antibiotics. While ASPs require complex change key behaviours on individual, team organization and policy levels, evidence from behavioural sciences is underutilized antibiotic studies across world, including high-income countries (HICs). A consensus procedure was performed propose research priority areas for optimizing effective implementation hospital settings using a perspective. <h3>Methods</h3> workgroup approaches convened response fourth call leading expert network proposals by Joint Programming Initiative Antimicrobial Resistance (JPIAMR). Eighteen clinical academic specialists stewardship, science behaviour four HICs with publicly funded healthcare systems (e.g. Canada, Germany, Norway UK) met face-to-face agree broad structured method. <i>Question addressed recommendations</i>: The process assessing ten identified resulted recommendations that need urgent scientific interest funding optimize inpatients systems. We suggest detail evidence–guided efforts following areas: (a) comprehensively identifying barriers facilitators implementing intended prescribing; (b) actors ('who') actions ('what needs be done') teams; (c) synthesizing available support future planning ASPs; (d) specifying activities current purpose defining control group comparison new initiatives; (e) balanced set outcomes measures evaluate effects interventions focused reducing unnecessary exposure antibiotics; (f) conducting robust evaluations built-in fidelity assessments; (g) designing (h) establishing base impact resistance; (i) investigating role government contexts (j) understanding what matters patients hospitals. <h3>Conclusions</h3> Assessment, revisions updates our priority-setting exercise should considered at intervals 2 years. To low- middle-income countries, methodology reported here could applied.