Developing core elements and checklist items for global hospital antimicrobial stewardship programmes: a consensus approach

Céline Pulcini (Lead / Corresponding author), Francesca Binda, Anjana Sankhil Lamkang, Anna Trett, Esmita Charani, Debra A. Goff, Stephan Harbarth, Sylvia Lemos Hinrichsen, Gabriel Levy-Hara, Marc Mendelson, Dilip Nathwani, Revathi Gunturu, Sanjeev Singh, Arjun Srinivasan, Visanu Thamlikitkul, Karin Thursky, Erika Vlieghe, Heiman Wertheim, Mei Zeng, Sumanth GandraRamanan Laxminarayan

    Research output: Contribution to journalArticle

    29 Citations (Scopus)
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    Abstract

    Objectives: With increasing global interest in hospital antimicrobial stewardship (AMS) programmes, there is a strong demand for core elements of AMS to be clearly defined on the basis of principles of effectiveness and affordability. To date, efforts to identify such core elements have been limited to Europe, Australia, and North America. The aim of this study was to develop a set of core elements and their related checklist items for AMS programmes that should be present in all hospitals worldwide, regardless of resource availability.

    Methods: A literature review was performed by searching Medline and relevant websites to retrieve a list of core elements and items that could have global relevance. These core elements and items were evaluated by an international group of AMS experts using a structured modified Delphi consensus procedure, using two-phased online in-depth questionnaires.

    Results: The literature review identified seven core elements and their related 29 checklist items from 48 references. Fifteen experts from 13 countries in six continents participated in the consensus procedure. Ultimately, all seven core elements were retained, as well as 28 of the initial checklist items plus one that was newly suggested, all with ≥80% agreement; 20 elements and items were rephrased.

    Conclusions: This consensus on core elements for hospital AMS programmes is relevant to both high- and low-to-middle-income countries and could facilitate the development of national AMS stewardship guidelines and adoption by healthcare settings worldwide.

    Original languageEnglish
    Pages (from-to)20-25
    Number of pages6
    JournalClinical Microbiology and Infection
    Volume25
    Issue number1
    Early online date3 Apr 2018
    DOIs
    Publication statusPublished - Jan 2019

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    Keywords

    • Antimicrobial resistance
    • Antimicrobial stewardship
    • Hospital
    • Low-income country
    • Middle-income country

    Cite this

    Pulcini, Céline ; Binda, Francesca ; Lamkang, Anjana Sankhil ; Trett, Anna ; Charani, Esmita ; Goff, Debra A. ; Harbarth, Stephan ; Hinrichsen, Sylvia Lemos ; Levy-Hara, Gabriel ; Mendelson, Marc ; Nathwani, Dilip ; Gunturu, Revathi ; Singh, Sanjeev ; Srinivasan, Arjun ; Thamlikitkul, Visanu ; Thursky, Karin ; Vlieghe, Erika ; Wertheim, Heiman ; Zeng, Mei ; Gandra, Sumanth ; Laxminarayan, Ramanan. / Developing core elements and checklist items for global hospital antimicrobial stewardship programmes : a consensus approach. In: Clinical Microbiology and Infection. 2019 ; Vol. 25, No. 1. pp. 20-25.
    @article{1cc737e85e9d4878a5186d3e73e847a4,
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    abstract = "Objectives: With increasing global interest in hospital antimicrobial stewardship (AMS) programmes, there is a strong demand for core elements of AMS to be clearly defined on the basis of principles of effectiveness and affordability. To date, efforts to identify such core elements have been limited to Europe, Australia, and North America. The aim of this study was to develop a set of core elements and their related checklist items for AMS programmes that should be present in all hospitals worldwide, regardless of resource availability.Methods: A literature review was performed by searching Medline and relevant websites to retrieve a list of core elements and items that could have global relevance. These core elements and items were evaluated by an international group of AMS experts using a structured modified Delphi consensus procedure, using two-phased online in-depth questionnaires.Results: The literature review identified seven core elements and their related 29 checklist items from 48 references. Fifteen experts from 13 countries in six continents participated in the consensus procedure. Ultimately, all seven core elements were retained, as well as 28 of the initial checklist items plus one that was newly suggested, all with ≥80{\%} agreement; 20 elements and items were rephrased.Conclusions: This consensus on core elements for hospital AMS programmes is relevant to both high- and low-to-middle-income countries and could facilitate the development of national AMS stewardship guidelines and adoption by healthcare settings worldwide.",
    keywords = "Antimicrobial resistance, Antimicrobial stewardship, Hospital, Low-income country, Middle-income country",
    author = "C{\'e}line Pulcini and Francesca Binda and Lamkang, {Anjana Sankhil} and Anna Trett and Esmita Charani and Goff, {Debra A.} and Stephan Harbarth and Hinrichsen, {Sylvia Lemos} and Gabriel Levy-Hara and Marc Mendelson and Dilip Nathwani and Revathi Gunturu and Sanjeev Singh and Arjun Srinivasan and Visanu Thamlikitkul and Karin Thursky and Erika Vlieghe and Heiman Wertheim and Mei Zeng and Sumanth Gandra and Ramanan Laxminarayan",
    note = "SG received a grant from the WISH foundation (http://www.wish-qatar.org) to compensate for his time on this project. This work will be presented at the WISH forum, and travel costs for CP, FB, SG, and RL to the forum will be covered by the WISH foundation. However, the funder had no role in the conduct of our research.",
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    Pulcini, C, Binda, F, Lamkang, AS, Trett, A, Charani, E, Goff, DA, Harbarth, S, Hinrichsen, SL, Levy-Hara, G, Mendelson, M, Nathwani, D, Gunturu, R, Singh, S, Srinivasan, A, Thamlikitkul, V, Thursky, K, Vlieghe, E, Wertheim, H, Zeng, M, Gandra, S & Laxminarayan, R 2019, 'Developing core elements and checklist items for global hospital antimicrobial stewardship programmes: a consensus approach', Clinical Microbiology and Infection, vol. 25, no. 1, pp. 20-25. https://doi.org/10.1016/j.cmi.2018.03.033

    Developing core elements and checklist items for global hospital antimicrobial stewardship programmes : a consensus approach. / Pulcini, Céline (Lead / Corresponding author); Binda, Francesca; Lamkang, Anjana Sankhil; Trett, Anna; Charani, Esmita; Goff, Debra A.; Harbarth, Stephan; Hinrichsen, Sylvia Lemos; Levy-Hara, Gabriel; Mendelson, Marc; Nathwani, Dilip; Gunturu, Revathi; Singh, Sanjeev; Srinivasan, Arjun; Thamlikitkul, Visanu; Thursky, Karin; Vlieghe, Erika; Wertheim, Heiman; Zeng, Mei; Gandra, Sumanth; Laxminarayan, Ramanan.

    In: Clinical Microbiology and Infection, Vol. 25, No. 1, 01.2019, p. 20-25.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - Developing core elements and checklist items for global hospital antimicrobial stewardship programmes

    T2 - a consensus approach

    AU - Pulcini, Céline

    AU - Binda, Francesca

    AU - Lamkang, Anjana Sankhil

    AU - Trett, Anna

    AU - Charani, Esmita

    AU - Goff, Debra A.

    AU - Harbarth, Stephan

    AU - Hinrichsen, Sylvia Lemos

    AU - Levy-Hara, Gabriel

    AU - Mendelson, Marc

    AU - Nathwani, Dilip

    AU - Gunturu, Revathi

    AU - Singh, Sanjeev

    AU - Srinivasan, Arjun

    AU - Thamlikitkul, Visanu

    AU - Thursky, Karin

    AU - Vlieghe, Erika

    AU - Wertheim, Heiman

    AU - Zeng, Mei

    AU - Gandra, Sumanth

    AU - Laxminarayan, Ramanan

    N1 - SG received a grant from the WISH foundation (http://www.wish-qatar.org) to compensate for his time on this project. This work will be presented at the WISH forum, and travel costs for CP, FB, SG, and RL to the forum will be covered by the WISH foundation. However, the funder had no role in the conduct of our research.

    PY - 2019/1

    Y1 - 2019/1

    N2 - Objectives: With increasing global interest in hospital antimicrobial stewardship (AMS) programmes, there is a strong demand for core elements of AMS to be clearly defined on the basis of principles of effectiveness and affordability. To date, efforts to identify such core elements have been limited to Europe, Australia, and North America. The aim of this study was to develop a set of core elements and their related checklist items for AMS programmes that should be present in all hospitals worldwide, regardless of resource availability.Methods: A literature review was performed by searching Medline and relevant websites to retrieve a list of core elements and items that could have global relevance. These core elements and items were evaluated by an international group of AMS experts using a structured modified Delphi consensus procedure, using two-phased online in-depth questionnaires.Results: The literature review identified seven core elements and their related 29 checklist items from 48 references. Fifteen experts from 13 countries in six continents participated in the consensus procedure. Ultimately, all seven core elements were retained, as well as 28 of the initial checklist items plus one that was newly suggested, all with ≥80% agreement; 20 elements and items were rephrased.Conclusions: This consensus on core elements for hospital AMS programmes is relevant to both high- and low-to-middle-income countries and could facilitate the development of national AMS stewardship guidelines and adoption by healthcare settings worldwide.

    AB - Objectives: With increasing global interest in hospital antimicrobial stewardship (AMS) programmes, there is a strong demand for core elements of AMS to be clearly defined on the basis of principles of effectiveness and affordability. To date, efforts to identify such core elements have been limited to Europe, Australia, and North America. The aim of this study was to develop a set of core elements and their related checklist items for AMS programmes that should be present in all hospitals worldwide, regardless of resource availability.Methods: A literature review was performed by searching Medline and relevant websites to retrieve a list of core elements and items that could have global relevance. These core elements and items were evaluated by an international group of AMS experts using a structured modified Delphi consensus procedure, using two-phased online in-depth questionnaires.Results: The literature review identified seven core elements and their related 29 checklist items from 48 references. Fifteen experts from 13 countries in six continents participated in the consensus procedure. Ultimately, all seven core elements were retained, as well as 28 of the initial checklist items plus one that was newly suggested, all with ≥80% agreement; 20 elements and items were rephrased.Conclusions: This consensus on core elements for hospital AMS programmes is relevant to both high- and low-to-middle-income countries and could facilitate the development of national AMS stewardship guidelines and adoption by healthcare settings worldwide.

    KW - Antimicrobial resistance

    KW - Antimicrobial stewardship

    KW - Hospital

    KW - Low-income country

    KW - Middle-income country

    U2 - 10.1016/j.cmi.2018.03.033

    DO - 10.1016/j.cmi.2018.03.033

    M3 - Article

    C2 - 29625170

    VL - 25

    SP - 20

    EP - 25

    JO - Clinical Microbiology and Infection

    JF - Clinical Microbiology and Infection

    SN - 1198-743X

    IS - 1

    ER -