Essential Resources and Strategies for Antibiotic Stewardship Programs in the Acute Care Setting

Area of Science:

• Infectious Diseases
• Health Services Research
• Antimicrobial Resistance

Background:

• Antibiotic stewardship programs (ASPs) are vital for improving patient outcomes and combating antibiotic resistance.
• Current guidance on essential resources for structuring ASPs is insufficient.
• This study addresses the need for resource recommendations by examining staffing structures in US acute care settings.

Purpose of the Study:

• To survey existing antibiotic stewardship programs in the US.
• To analyze the relationship between staffing levels and program effectiveness.
• To develop recommendations for optimal staffing structures in acute care settings.

Main Methods:

• A cross-sectional survey was distributed to members of three infectious diseases subspecialty societies involved in ASPs.
• Descriptive statistics were used to analyze survey responses.
• Logistic regression models identified factors influencing program effectiveness and mediating strategies.

Main Results:

• 244 acute care programs responded, reporting common strategies like prior authorization and prospective audit and feedback.
• 85% of surveyed programs achieved effectiveness in at least one outcome.
• Each 0.5 FTE increase in pharmacist and physician support predicted a 1.48-fold increase in effectiveness, mediated by prospective audit and feedback.

Conclusions:

• A proposed FTE-to-bed ratio can guide resource discussions for ASPs.
• Prospective audit and feedback should be central to ASPs.
• Physician leadership and specialized pharmacists are critical for ASP success.