[Monitoring activities and improvement in the use of antibiotics in Spanish hospitals: results of a national survey]

Abstract

Objectives: To describe: 1) the main features of antimicrobial stewardship activities (ASA) in Spanish hospitals and 2) the perceptions of the Spanish Infectious Diseases (ID) community on ASA.

Methods: An online survey was designed and distributed through the e-mailing lists of several working groups of the Spanish Clinical Microbiology and Infectious Diseases Society.

Results: Between September 15 and November 23, 2009, surveys representing 78 hospitals were received. Most of the respondents were either ID physicians (30%) or microbiologists (29%), and 31/78 hospitals (40%) had ongoing ASA. These hospitals were concentrated in 4 of the 17 regions, particularly in Catalonia. Professionals belonging to 26/31 centres with ASA completed the survey. The most frequent principles of antibiotic (ABX) stewardship implemented in these programs were: 1) ABX streamlining (22/26) and 2) intravenous to oral switch (22/26) followed by 3) strategic monitoring of ABX (21/26). In 22/26 (86%) of the centres with ASA any physician could initially prescribe any of the antimicrobials included in the formulary. The most frequent activity carried out was ABX restriction, 69% (18/26) followed by conferences 61% (16/26) and therapeutic audit and feed-back 54% (14/26). When asked which antimicrobials that should be closely monitored, carbapenems were considered by all respondents in centres with ongoing ASA.

Conclusions: 1) A minority (40%) of the surveyed hospitals in Spain has an ongoing ASA and large geographical variations were observed. 2) ASA were most commonly structured in the form of an integrated part-time multidisciplinary team of ID physicians and Pharmacists, and 3) Carbapenems were considered the ABX most required to be monitored.