Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-22T22:50:46.907Z Has data issue: false hasContentIssue false

The State of Antimicrobial Stewardship Programs in California

Published online by Cambridge University Press:  02 January 2015

Kavita K. Trivedi*
Affiliation:
Healthcare-Associated Infections Program, California Department of Public Health, Richmond, California
Jon Rosenberg
Affiliation:
Healthcare-Associated Infections Program, California Department of Public Health, Richmond, California
*
Healthcare-Associated Infections Program, California Department of Public Health, 850 Marina Bay Parkway, Building E, 1st Floor, Richmond, CA 94804 ([email protected])

Abstract

Objective.

To assess antimicrobial stewardship programs (ASPs) and strategies in California general acute care hospitals and to describe the effect of state legislation (Senate Bill 739) requiring hospitals to develop processes for evaluating the judicious use of antimicrobials.

Design.

Web-based survey of general acute care hospitals.

Participants.

All 422 general acute care hospital campuses in California were invited to participate.

Results.

Responses from 223 (53%) of California's general acute care hospital campuses were included and were statistically representative of all acute care hospital campuses by region but not bed size or rurality. Community hospitals represented 73% of respondents. Fifty percent of hospitals described a current ASP and 30% reported planning an ASP; of these, 51% reported measuring outcomes. Twenty percent of hospitals reported no planned ASP or uncertainty whether an ASP existed and described barriers including staffing constraints (47%), lack of funding (42%), and lack of initiation of a formal proposal to start an ASP (42%). Of 135 responding hospitals, 22% reported that Senate Bill 739 influenced initiation of their ASP.

Conclusions.

Although many studies have been published that describe hospital-specific ASPs, most have been described within academic centers, and there are limited assessments of ASP strategies across hospital systems. Our study verifies that many ASPs exist in California, particularly in community settings where a scarcity of antimicrobial restriction was thought to exist. Additionally, Senate Bill 739 appears to have played a role in initiating many hospital ASPs, which supports the adoption of similar legislation in other states and nationally.

Type
Original Article
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2013

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Dellit, TH, Owens, RC, McGowan, JE Jret al.Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America guidelines for developing an institutional program to enhance antimicrobial stewardship. Clin Infect Dis 2007;44(2): 159177.CrossRefGoogle Scholar
2.Goff, DA. Antimicrobial stewardship: bridging the gap between quality care and cost. Curr Opin Infect Dis 2011;24(suppl 1): S11S20.CrossRefGoogle Scholar
3.Ohl, CA, Luther, VP. Antimicrobial stewardship for inpatient facilities. J Hosp Med 2011;6(suppl 1):S4S15.CrossRefGoogle ScholarPubMed
4.Drew, RH, White, R, MacDougall, C, Hermsen, ED, Owens, RC Jr. Insights from the Society of Infectious Diseases Pharmacists on antimicrobial stewardship guidelines from the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America. Pharmacotherapy 2009;29(5):593607.CrossRefGoogle Scholar
5.Bal, AM, Gould, IM. Antibiotic stewardship: overcoming implementation barriers. Curr Opin Infect Dis 2011;24(4):357362.CrossRefGoogle ScholarPubMed
6.Pope, SD, Dellit, TH, Owens, RC, Hooton, TM. Results of survey on implementation of Infectious Diseases Society of America and Society for Healthcare Epidemiology of America guidelines for developing an institutional program to enhance antimicrobial stewardship. Infect Control Hosp Epidemiol 2009;30(1):9798.CrossRefGoogle Scholar
7.The Association of State and Territorial Health Officials; Centers for Disease Control and Prevention (CDC). Policies for Eliminating Healthcare-Associated Infections. Atlanta, GA: CDC, 2012.Google Scholar
8.Goldstein, EJC, Trivedi, K. Antimicrobial stewardship: the view from California. Infect Dis Clin Pract (Baltim Md) 2012;20:294296.CrossRefGoogle Scholar
9. California Department of Public Health. The California Antimicrobial Stewardship Program Initiative. http://www.cdph.ca.gov/programs/hai/Pages/AntimicrobialStewardshipProgramlnitiative.aspx.Google Scholar
10.Standiford, HC, Chan, S, Tripoli, M, Weekes, E, Forrest, GN. Antimicrobial stewardship at a large tertiary care academic medical center: cost analysis before, during, and after a 7-year program. Infect Control Hosp Epidemiol 2012;33(4):338345.CrossRefGoogle Scholar
11.Dumartin, C, Rogues, AM, Amadeo, B, et al.Antibiotic usage in south-western French hospitals: trends and association with antibiotic stewardship measures. J Antimicrob Chemother 2011;66(7):16311637.CrossRefGoogle ScholarPubMed
12.Vander Stichele, RH, Elseviers, MM, Ferech, M, Blot, S, Goossens, H. Hospital consumption of antibiotics in 15 European countries: results of the ESAC Retrospective Data Collection (1997–2002). J Antimicrob Chemother 2006;58(1):159167.CrossRefGoogle ScholarPubMed
13.European Surveillance of Antimicrobial Consumption (ESAC). ESAC Yearbook 2008. http://www.ecdc.europa.eu/en/activities/surveillance/esac-net/publications/documents/esac_yearbook_2008.pdf. ESAC, 2010. Accessed June 25, 2012.Google Scholar
14.Dumartin, C, Rogues, AM, Amadeo, B, et al.Antibiotic stewardship programmes: legal framework and structure and process indicator in Southwestern French hospitals, 2005–2008. J Hosp Infect 2011;77(2):123128.CrossRefGoogle ScholarPubMed
15.Policy statement on antimicrobial stewardship by the Society for Healthcare Epidemiology of America (SHEA), the Infectious Diseases Society of America (IDSA), and the Pediatric Infectious Diseases Society (PIDS). Infect Control Hosp Epidemiol 2012;33(4):322327.CrossRefGoogle Scholar
16.McQuillen, DP, Petrak, RM, Wasserman, RB, Nahass, RG, Scull, JA, Martinelli, LP. The value of infectious diseases specialists: non-patient care activities. Clin Infect Dis 2008;47(8):10511063.CrossRefGoogle ScholarPubMed
17.Goff, DA, Bauer, KA, Reed, EE, Stevenson, KB, Taylor, JJ, West, JE. Is the “low-hanging fruit” worth picking for antimicrobial stewardship programs? Clin Infect Dis 2012;55(4):587597.CrossRefGoogle Scholar
18.Septimus, EJ, Owens, RC Jr. Need and potential of antimicrobial stewardship in community hospitals. Clin Infect Dis 2011;53(suppl 1):S8S14.CrossRefGoogle ScholarPubMed
19.Pedersen, CA, Schneider, PJ, Scheckelhoff, DJ. ASHP national survey of pharmacy practice in hospital settings: prescribing and transcribing, 2010. Am J Health Syst Pharm 2011;68(8):669688.CrossRefGoogle ScholarPubMed
20.Zillich, AJ, Sutherland, JM, Wilson, SJ, et al.Antimicrobial use control measures to prevent and control antimicrobial resistance in US hospitals. Infect Control Hosp Epidemiol 2006;27(10):10881095.CrossRefGoogle ScholarPubMed
21.Johannsson, B, Beekmann, SE, Srinivasan, A, Hersh, AL, Laxminarayan, R, Polgreen, PM. Improving antimicrobial stewardship: the evolution of programmatic strategies and barriers. Infect Control Hosp Epidemiol 2011;32(4):367374.CrossRefGoogle ScholarPubMed