Antimicrobial stewardship in the primary care setting: from dream to reality?
Abstract Background Clinicians who work in primary care are potentially the most influential healthcare professionals to address the problem of antibiotic resistance because this is where most antibiotics are prescribed. Despite a number of evidence based interventions targeting the management of co...
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doaj-b1b7baf1c8024f2cb8df78cdd905f6c32020-11-25T02:48:09ZengBMCBMC Family Practice1471-22962020-07-012111910.1186/s12875-020-01191-0Antimicrobial stewardship in the primary care setting: from dream to reality?M. L. Avent0S. E. Cosgrove1E. G. Price-Haywood2M. L. van Driel3Statewide Antimicrobial Stewardship Program, Queensland HealthDepartment of Medicine, Division of Infectious Diseases, Johns Hopkins University School of MedicineOchsner Health System, Center for Outcomes and Health Services ResearchPrimary Care Clinical Unit, Faculty of Medicine, The University of QueenslandAbstract Background Clinicians who work in primary care are potentially the most influential healthcare professionals to address the problem of antibiotic resistance because this is where most antibiotics are prescribed. Despite a number of evidence based interventions targeting the management of community infections, the inappropriate antibiotic prescribing rates remain high. Discussion The question is how can appropriate prescribing of antibiotics through the use of Antimicrobial Stewardship (AMS) programs be successfully implemented in primary care. We discuss that a top-down approach utilising a combination of strategies to ensure the sustainable implementation and uptake of AMS interventions in the community is necessary to support clinicians and ensure a robust implementation of AMS in primary care. Specifically, we recommend a national accreditation standard linked to the framework of Core Elements of Outpatient Antibiotic Stewardship, supported by resources to fund the implementation of AMS interventions that are connected to quality improvement initiatives. This article debates how this can be achieved. Summary The paper highlights that in order to support the sustainable uptake of AMS programs in primary care, an approach similar to the hospital and post-acute care settings needs to be adopted, utilising a combination of behavioural and regulatory processes supported by sustainable funding. Without these strategies the problem of inappropriate antibiotic prescribing will not be adequately addressed in the community and the successful implementation and uptake of AMS programs will remain a dream.http://link.springer.com/article/10.1186/s12875-020-01191-0Antimicrobial stewardshipAntibiotic stewardshipAntimicrobialresistance; primary care; outpatient setting. |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
M. L. Avent S. E. Cosgrove E. G. Price-Haywood M. L. van Driel |
spellingShingle |
M. L. Avent S. E. Cosgrove E. G. Price-Haywood M. L. van Driel Antimicrobial stewardship in the primary care setting: from dream to reality? BMC Family Practice Antimicrobial stewardship Antibiotic stewardship Antimicrobial resistance; primary care; outpatient setting. |
author_facet |
M. L. Avent S. E. Cosgrove E. G. Price-Haywood M. L. van Driel |
author_sort |
M. L. Avent |
title |
Antimicrobial stewardship in the primary care setting: from dream to reality? |
title_short |
Antimicrobial stewardship in the primary care setting: from dream to reality? |
title_full |
Antimicrobial stewardship in the primary care setting: from dream to reality? |
title_fullStr |
Antimicrobial stewardship in the primary care setting: from dream to reality? |
title_full_unstemmed |
Antimicrobial stewardship in the primary care setting: from dream to reality? |
title_sort |
antimicrobial stewardship in the primary care setting: from dream to reality? |
publisher |
BMC |
series |
BMC Family Practice |
issn |
1471-2296 |
publishDate |
2020-07-01 |
description |
Abstract Background Clinicians who work in primary care are potentially the most influential healthcare professionals to address the problem of antibiotic resistance because this is where most antibiotics are prescribed. Despite a number of evidence based interventions targeting the management of community infections, the inappropriate antibiotic prescribing rates remain high. Discussion The question is how can appropriate prescribing of antibiotics through the use of Antimicrobial Stewardship (AMS) programs be successfully implemented in primary care. We discuss that a top-down approach utilising a combination of strategies to ensure the sustainable implementation and uptake of AMS interventions in the community is necessary to support clinicians and ensure a robust implementation of AMS in primary care. Specifically, we recommend a national accreditation standard linked to the framework of Core Elements of Outpatient Antibiotic Stewardship, supported by resources to fund the implementation of AMS interventions that are connected to quality improvement initiatives. This article debates how this can be achieved. Summary The paper highlights that in order to support the sustainable uptake of AMS programs in primary care, an approach similar to the hospital and post-acute care settings needs to be adopted, utilising a combination of behavioural and regulatory processes supported by sustainable funding. Without these strategies the problem of inappropriate antibiotic prescribing will not be adequately addressed in the community and the successful implementation and uptake of AMS programs will remain a dream. |
topic |
Antimicrobial stewardship Antibiotic stewardship Antimicrobial resistance; primary care; outpatient setting. |
url |
http://link.springer.com/article/10.1186/s12875-020-01191-0 |
work_keys_str_mv |
AT mlavent antimicrobialstewardshipintheprimarycaresettingfromdreamtoreality AT secosgrove antimicrobialstewardshipintheprimarycaresettingfromdreamtoreality AT egpricehaywood antimicrobialstewardshipintheprimarycaresettingfromdreamtoreality AT mlvandriel antimicrobialstewardshipintheprimarycaresettingfromdreamtoreality |
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