Hospital-based Antimicrobial Stewardship in Denmark, Greenland, and the Faroe Islands – Current landscape and barriers

• Published in: Journal of Hospital Infection
• Main Authors: Kraef, Christian, Öbrink-Hansen, Kristina, Hertz, Mathias, Hagen, Trine Langfeldt, Deutch, Susanna, Holler, Jon Gitz, Olesen, Birthe Riis, Holm, Mette, Gaini, Shahin, Koch, Anders, Benfield, Thomas, Rosenvinge, Flemming S., Johansen, Isik Somuncu
• Format: Article in Journal/Newspaper
• Language: English
• Published: 2024
• Subjects: Faroe Islands; Greenland
• Online Access: https://portal.findresearcher.sdu.dk/da/publications/c0361bfd-f872-4204-a2b1-308d2bfd1fea; https://doi.org/10.1016/j.jhin.2024.01.018; https://findresearcher.sdu.dk/ws/files/256307224/PIIS0195670124000409.pdf

OBJECTIVES: To describe the current organization and implementation of formalized, multi-disciplinary hospital-based antimicrobial stewardship (AMS) structures in Denmark, the Faroe Islands and Greenland. METHODS: A structured electronic questionnaire was sent to all trainees and specialists in clinical microbiology (N=207) and infectious diseases (N=260), as well as clinical pharmacists (N=20) and paediatricians (N=10) with expertise in infectious diseases. The survey had 30 multiple-choice, rating-scale, and open-ended questions based on an international consensus checklist for hospital AMS, adapted to a Danish context. RESULTS: Overall, 145 individual responses representing 20 hospitals were received. Nine hospitals (45%) reported a formal AMS strategy, eight (40%) a formal organizational multi-disciplinary structure and a multi-disciplinary AMS team, and six (30%) a designated professional as a leader of the AMS team. A majority of hospitals reported access to updated guidelines (80%) and regularly monitored and reported the quantity of antibiotics prescribed (70% and 65%, respectively). Only one hospital (5%) reported a dedicated, sustainable and sufficient AMS budget, three hospitals (15%) audited courses of therapy for specific agents/clinical conditions and four hospitals (20%) had a document clearly defining roles, procedures of collaboration and responsibilities for AMS. A total of 42% of all individual respondents had received formal AMS training. Main barriers were a lack of financial resources (52%), a lack of mandate from the hospital management (30%) and AMS not being a priority (18%). CONCLUSIONS: Core elements important for multi-disciplinary hospital-based AMS can be strengthened in Danish hospitals. Funding, clear mandates, prioritization from the hospital management and the implementation of multi-disciplinary AMS structures may help close the identified gaps.