Cross-sectional survey to assess the status of antimicrobial stewardship programs in public Chilean hospitals

Antimicrobial resistance is a leading cause of death worldwide, with the highest burdens in low-resource settings. Antimicrobial stewardship programs (ASP) are coordinated interventions designed to improve and measure the appropriate use of antimicrobials. In December 2020, the Ministry of Health of Chile mandated that all hospitals in the country implement an ASP, but there has been little rigorous, comparable information on the prevalence and types of ASP activities currently occurring in Chilean hospitals, which is critical for infection control officials and health decision-makers.

We aimed to assess the current degree of implementation of ASPs in Chilean public hospitals using a web-based survey.

Of 66 responses, 57 hospitals (86.4%) reported having an ASP and were used as the denominator in the analyses. Among them, 39 (68.4%) reported having a written institutional protocol. On average, the hospitals performed seven antimicrobial optimization activities (range 1-9). For hospitals that have WHO Reserve group antibiotics, use authorization was almost universally required (90.9% to 100%). Prospective audit and feedback was performed in 64.9% of the institutions. Seventeen hospitals (29.8%) did not measure their antibiotic consumption. The median ASP implementation survey score was 68.4 points (ranging from 30.7 to 96.5).

These findings show a variable implementation of ASP activities in Chilean hospitals and provide the necessary information to establish the baseline for the implementation of ASPs in hospitals in Chile.