Building an antimicrobial stewardship program: a narrative of six years under the Donabedian perspective

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dc.creatorAmanda Fonseca Medeiros
dc.creatorCaryne Margotto Bertollo
dc.creatorAdriano Max Moreira Reis
dc.creatorMonica Aparecida Costa
dc.creatorEdna Marilea Meireles Leite
dc.creatorSimony da Silva Gonçalves
dc.creatorMauro Henrique Nogueira Guimarães de Abreu
dc.creatorRenan Pedra de Souza
dc.creatorMaria Auxiliadora Parreiras Martins
dc.date.accessioned2025-02-24T21:18:57Z
dc.date.accessioned2025-09-09T00:58:57Z
dc.date.available2025-02-24T21:18:57Z
dc.date.issued2023-03-21
dc.description.sponsorshipCAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
dc.format.mimetypepdf
dc.identifier.doihttps://doi.org/10.3389/fphar.2023.1074389
dc.identifier.issn16639812
dc.identifier.urihttps://hdl.handle.net/1843/80392
dc.languageeng
dc.publisherUniversidade Federal de Minas Gerais
dc.relationPrograma Institucional de Internacionalização – CAPES - PrInt
dc.relation.ispartofFrontiers in Pharmacology
dc.rightsAcesso Aberto
dc.subjectSaúde
dc.subjectGarantia de qualidade
dc.subjectFarmacoepidemiologia
dc.subjectAgentes antiinfecciosos
dc.subjectResistência à drogas
dc.subject.otherAntimicrobial stewardship
dc.subject.otherDrug resistance microbial
dc.subject.otherOutcome assessment health care
dc.subject.otherHealth care
dc.subject.otherQuality assurance
dc.subject.otherPharmacoepidemiology
dc.titleBuilding an antimicrobial stewardship program: a narrative of six years under the Donabedian perspective
dc.typeArtigo de periódico
local.citation.epage10
local.citation.spage1
local.citation.volume14
local.description.resumoIntroduction: Antimicrobial resistance (AMR) is increasing and represents one of the world’s major challenges. AMR increase morbimortality, length of hospital stay and costs. Antimicrobial Stewardship Programs (ASP) are one of the key strategies to promote the rational use of antimicrobials since AMR is mostly driven by antimicrobial consumption. Objective: To describe the ASP implementation in a teaching hospital from the perspective of Donabedian quality assessment and the Brazilian regulatory requirements. Method: This was a descriptive study with secondary data collection, including document review of the ASP. The study setting was a general public 392-bed hospital. The ASP activities were performed by the hospital infection control committee (HICC), hospital pharmacy (HP) and diagnostic support laboratory (DSL). The description of the three services mainly involved in the ASP was based on a quality assessment model involving the dimensions of “structure”, “process” and “result” proposed by Donabedian. The distribution among dimensions was guided by the checklist of essential elements of the ASP that compose the Brazilian regulatory requirements. The checklist was applied in July, 2022, and the ASP results described from 2016 to 2021. Results: ASP actions have been gradually implemented since 2008 with the implementation of HICC and improved over the years. Regarding structure, the investments in technology were mapped, quantifying 26 computers and three software programs employed to computerize the ASP processes performed in specific physical areas by HICC, HP and DSL. Institutional guidelines used by HICC, HP and DSL guided clinical practices to operationalize ASP. The evaluation metrics improved for 10 indicators and worsened for four indicators. From the 60 items. Conclusion: This study described the implementation of ASP in a teaching hospital, applying the Donabedian perspective. Although the hospital still does not have a classic ASP model, there were investments to improve structure, processes and results, aiming to comply with international guidelines. A high proportion of key elements of ASP in the hospital were followed according to the Brazilian regulatory requirements. Aspects related to antimicrobial consumption and the emergence of microbial resistance deserve further investigations.
local.identifier.orcidhttps://orcid.org/0000-0002-6747-6172
local.identifier.orcidhttps://orcid.org/0000-0002-4115-559X
local.identifier.orcidhttps://orcid.org/0000-0002-0017-7338
local.identifier.orcidhttps://orcid.org/0000-0002-2151-5033
local.identifier.orcidhttps://orcid.org/0000-0002-6926-4851
local.identifier.orcidhttps://orcid.org/0000-0001-9352-5460
local.identifier.orcidhttps://orcid.org/0000-0001-8794-5725
local.identifier.orcidhttps://orcid.org/0000-0002-9479-4432
local.identifier.orcidhttps://orcid.org/0000-0002-5211-411X
local.publisher.countryBrasil
local.publisher.departmentFAO - DEPARTAMENTO DE ODONTOLOGIA SOCIAL E PREVENTIVA
local.publisher.departmentFAR - DEPARTAMENTO DE PRODUTOS FARMACÊUTICOS
local.publisher.initialsUFMG
local.url.externahttps://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2023.1074389/full

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