The report 'Global core standards for hospital antimicrobial stewardship programs'centres on a Checklist for Hospital Antimicrobial Stewardship Programming (CHASP), 'designed to help hospitals
assess whether their antimicrobial stewardship programs (ASPs) contain core essential elements for success.' http://www.wish.org.qa/wp-content/uploads/2018/11/IMPJ6078-WISH-2018-LHS...
Among the many checklist items are:
- Does your hospital offer a range of educational resources to support staff training on how to optimize antimicrobial prescribing?
- Do the AMS team members receive regular training in antimicrobial prescribing and stewardship?
- Does your hospital have an antimicrobial formulary (that is, a list of antimicrobials that have been approved for hospital use, specifying whether the drugs are unrestricted, restricted – approval of an AMS team member is required – or permitted for specific conditions)?
- Does your hospital have available and up-to-date recommendations for infection management (diagnosis, prevention and treatment), based on international/national evidence-based guidelines and local susceptibility (when possible), to assist with antimicrobial selection (indication, agent, dose, route and duration) for common clinical conditions?
1. Our colleagues at WHO have previously emphasised the importance of clinical practice guidelines in promoting rational prescribing but I couldn't find these mentioned in this report. Instead the emphasis seems to be on 'educational resources' and formularies (described here as what people are allowed to prescribe, rather than on guidance as may be found in the British National Formulary).
2. I do not know the statistics, but irrational prescribing of antibiotics in hospital settings probably account for only a tiny fraction (less than 5%?) of all irrational prescribing. That said, hospitals are perhaps extremely important hotspots for the emergence of new resistant organisms.
Can any HIFA members comment further on any aspect of the above?
Best wishes, Neil
Joint Coordinator HIFA Project on Information for Prescribers and Users of Medicines
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HIFA profile: Neil Pakenham-Walsh is coordinator of the HIFA global health campaign (Healthcare Information For All - www.hifa.org ), a global community with more than 18,000 members in 177 countries, interacting on six global forums in four languages. He also currently chairs the Dgroups Foundation (www.dgroups.info), which supports 800 communities of practice on international development, health and social justice. Twitter: @hifa_org FB: facebook.com/HIFAdotORG /orcid.org/0000-0001-9557-1487 firstname.lastname@example.org