Characteristics of antimicrobial stewardship programmes in rural East Texas hospitals

Antimicrobial stewardship programmes (ASPs) serve as the primary method to prevent and manage the development of antimicrobial resistance. Rural settings may lack the recommended personnel and resources needed to provide antimicrobial stewardship services.

An electronic survey was distributed via e-mail to pharmacy directors or antimicrobial stewardship programme directors of licensed hospitals within Public Health Region 4/5N of East Texas.

Sixty percent of ASPs were established <12 months prior to the survey administration. All ASPs had pharmacist involvement, with only one (5%) having formal infectious diseases (ID) training through postgraduate education. Ninety percent of ASPs had a physician champion, with five (27.8%) physicians having formal ID training. Most institutions lacked one or more recommended antimicrobial stewardship practices. When compared with ASPs established for <12 months, ASPs existing for at least 12 months were more likely to have protocols to change antimicrobials from intravenous to enteral forms (100% vs 50%, P = 0.042), provide education to patients and families on appropriate antimicrobial use (87.5% vs 33.3%, P = 0.028), and track antimicrobial purchasing costs (87.5% vs 33.3%, P = 0.028).

Institutions in rural settings require additional resources, personnel, and time to implement ASPs and perform various antimicrobial stewardship practices.