Antibiotic stewardship is a global health concern, and multi-disciplinary teams need both staffing and stable funding in order to combat the threat, microbiology researchers said.

This multi-step process would involve devising global minimum staffing standards, a list of core activities, and an estimate of personnel needed to ensure these program were successful both in hospitals and all healthcare settings, wrote Céline Pulcini, MD, an infectious disease specialist at University of Lorraine in France, and colleagues.

In a commentary published in Clinical Microbiology and Infection, a journal of the European Society of Clinical Microbiology and Infectious Diseases, Pulcini and colleagues argued that antibiotic stewardship programs remain "understaffed or non-existent" in most countries throughout the world. Even in countries, such as the U.S., with certain measures that mandate antibiotic stewardship programs in hospitals, the authors noted that "these requirements are not always enforced in practice."

They cited recent research stating that an effective infection control program for an acute care hospital should include both a dedicated physician trained in infection control, as well as one full-time specifically trained nurse per 250 beds. However, they added that a U.S. study suggested that two full-time infectious disease physicians and one full-time infectious disease-trained clinical pharmacist per 1,000 acute care hospital beds are needed.

Because the list of core activities for antibiotic stewardship programs differs between countries, the authors called upon the global infectious disease community to develop lists of both core activities and basic resources, such as diagnostics and pharmacy programs, to help standardize antibiotic stewardship programs.

Trying to fund these programs is also a concern, and Pulcini's group argued that such resources could be used to train and retain core healthcare personnel, such as administrative staff and data support.

"Funding for [antibiotic stewardship] should not come from the assumed cost savings deriving from the lower drugs expenses, but rather should be an inherent part of patient safety and healthcare quality-related spending," they wrote.

Co-author Evelina Tacconelli, MD, of both University Hospital in Tübingen, Germany, and an executive committee member of the European Society of Clinical Microbiology and Infectious Diseases said that global and coordinated efforts are essential to drive this funding.

"This will not come cheap but the cost pales into insignificance compared to the costs associated with developing new antimicrobial drugs," she said in a statement.

Pulcini's group also cited "increasing difficulty" in bringing new antibiotics to the market and the "dramatic sums of money" that will be needed to do so, making optimal antibiotic use that much more important.

In addition to global staffing standards and identifying potential funding sources to cover the cost of antibiotic stewardship programs, the authors recommended that costs should be applied to global standards from "a sample of low, middle, and high-income countries."

 

SLOVNÍ ZÁSOBA

stewardship - dozor, správcovství

to staff - vybavit personálem; obsadit

funding - financování

to combat - bojovat, svádět boj; potírat co

threat - hrozba, nebezpečí; ohrožení; výhrůžka, pohrůžka, vyhrožování

to devise - navrhnout, vymyslet, vypracovat; nalézt; zkonstruovat

core - jádro, střed; dřeň;

understaffed - pod stavem, s malým stavem zaměstnanců

to mandate - řídit, ustanovit

to enforce - prosadit, uvést v platnost, uplatnit, vykonat; vynutit si

to call upon - vyzvat, apelovat; dovolávat se

concern - starost, znepokojení; zájem, účast, podíl; vztah

to retain - udržet, zadržet, zachytit

assumed - předpokládaný

expenses - výdaje, výlohy, náklady

inherent - vlastní, inherentní, neodmyslitelný, přirozený

quality-related spending - výdaje zajišťující a zaručující kvalitu

to pale into insignificance - stát se naprosto bezvýznamným

 

Ilustrační foto -zdroj: vubhb.cz