Authors

Massimo Sartelli, Macerata Hospital
Francesco M. Labricciosa, Università Politecnica delle Marche
Pamela Barbadoro, Università Politecnica delle Marche
Leonardo Pagani, Bolzano Central Hospital
Luca Ansaloni, Papa Giovanni XXIII Hospital
Adrian J. Brink, Milpark Hospital, University of Cape Town
Jean Carlet, World Alliance against Antibiotics Resistance
Ashish Khanna, Cleveland Clinic
Alain Chichom-Mefire, Regional Hospital
Federico Coccolini, Infermi Hospital
Salomone Di Saverio, Maggiore Hospital
Addison K. May, Vanderbilt University
Pierluigi Viale, University of Bologna
Richard R. Watkins, Cleveland Clinic Akron General, Northeast Ohio Medical University
Luigia Scudeller, IRCCS Policlinico San Matteo Foundation
Lilian M. Abbo, University of Miami
Fikri M. Abu-Zidan, UAE University
Abdulrashid K. Adesunkanmi, Obafemi Awolowo University
Sara Al-Dahir, Xavier University of Louisiana
Majdi N. Al-Hasan, University of South Carolina School
Halil Alis, Bakirkoy Dr Sadi Konuk Training and Research Hospital
Carlos Alves, São João Hospital Centre
André R. Araujo da Silva, Prontobaby Hospital da Criança
Goran Augustin, University Hospital Center
Miklosh Bala, Hadassah Hebrew University Medical Center
Philip S. Barie, Weill Cornell Medicine
Marcelo A. Beltrán, Hospital San Juan de Dios de La Serena
Aneel Bhangu, Queen Elizabeth Hospital
Belefquih Bouchra, Mohammed 6th University of Health Sciences
Stephen M. Brecher, Boston University
Miguel A. Caínzos, Hospital Clínico Universitario
Adrian Camacho-Ortiz, Hospital Universitario Dr Jose Eleuterio Gonzalez
Marco Catani, Umberto I Hospital
Sujith J. Chandy, Pushpagiri Institute of Medical Sciences and Research Centre
Asri Che Jusoh, Kuala Krai Hospital
Jill R. Cherry-Bukowiec, University of Michigan
Osvaldo Chiara, Niguarda Hospital
Elif Colak, Samsun Training and Research Hospital
Oliver A. Cornely, University of Cologne
Yunfeng Cui, Tianjin Medical University
Zaza Demetrashvili, Kipshidze Central University Hospital
Belinda De Simone, Cannes Hospital
Jan J. De Waele, Ghent University Hospital
Sameer Dhingra, The University of the West Indies, Uriah Butler Highway
Francesco Di Marzo, Versilia Hospita
Agron Dogjani, University Hospital of Trauma
Gereltuya Dorj, Mongolian National University
Laurent Dortet, Paris-Sud University
Therese M. Duane, John Peter Smith Health Network
Mutasim M. Elmangory, Federal Ministry of Health
Mushira A. Enani, King Fahad Medical City
Paula Ferrada, Virginia Commonwealth University
J. Esteban Foianini, Clinica Foianini
Mahir Gachabayov, Vladimir City Clinical Hospital of Emergency Medicine
Chinmay Gandhi, Bharati Vidyapeeth Deemed University
Wagih Mommtaz Ghnnam, Mansoura University
Helen Giamarellou, Hygeia General Hospital
Georgios Gkiokas, National and Kapodistrian University of Athens
Harumi Gomi, University of Tsukuba
Tatjana Goranovic, Sestre Milosrrdnice UHC
Ewen A. Griffiths, Queen Elizabeth Hospital
Rosio I. Guerra Gronerth, Peruvian Navy Medical Center
Julio C. Haidamus Monteiro, Santa Casa Hospital
Timothy C. Hardcastle, University of KwaZulu-Natal
Andreas Hecker, University Hospital Giessen
Adrien M. Hodonou, University of Parakou
Orestis Ioannidis, Aristotle University of Thessaloniki
Arda Isik, Erzincan University
Katia A. Iskandar, International University
Hossein S. Kafil, Tabriz University of Medical Sciences
Souha S. Kanj, American University of Beirut
Lewis J. Kaplan, University of Pennsylvania
Garima Kapoor, Gandhi Medical College
Aleksandar R. Karamarkovic, Medical Faculty University of Belgrade
Jakub Kenig, Jagiellonian University
Ivan Kerschaever, Regional Hospital of Tienen
Faryal Khamis, Royal Hospital
Vladimir Khokha, City Hospital
Ronald Kiguba, Makerere University
Hong B. Kim, Seoul National University Bundang Hospital
Wen-Chien Ko, National Cheng Kung University Hospital
Kaoru Koike, Kyoto University
Iryna Kozlovska, Higher educational institutions of Ukraine Bukovina State Medical University
Anand Kumar, University of Manitoba
Leonel Lagunes, Hospital Central Dr Ignacio Morones Prieto
Rifat Latifi, University of Arizona
Jae G. Lee, Yonsei University
Young R. Lee, Texas Tech University
Ari Leppäniemi, University Hospital Meilahti
Yousheng Li, Nanjing University
Stephen Y. Liang, Washington University
Warren Lowman, University of the Witwatersrand
Gustavo M. Machain, Universidad Nacional de Asuncion
Marc Maegele, University of Witten/Herdecke (UW/H)
Piotr Major, Jagiellonian University
Sydney Malama, University of Zambia
Ramiro Manzano-Nunez, Fundacion Valle del Lili
Athanasios Marinis, Tzaneion General Hospital
Isidro Martinez Casas, Hospital Complex of Jaén
Sanjay Marwah, Post-Graduate Institute of Medical Sciences
Emilio Maseda, Hospital Universitario La Paz Madrid
Michael E. McFarlane, University Hospital of the West Indies
Ziad Memish, Ministry of Health
Dominik Mertz, McMaster University
Cristian Mesina, Emergency Hospital of Craiova
Shyam K. Mishra, Tribhuvan University Teaching Hospital
Ernest E. Moore, University of Colorado, Boulder
Akutu Munyika, Onandjokwe Hospital
Eleftherios Mylonakis, Warren Alpert Medical School of Brown University
Lena Napolitano, University of Michigan
Ionut Negoi, Emergency Hospital of Bucharest
Milica D. Nestorovic, Clinical Centre
David P. Nicolau, Center of Anti-Infective Research and Development
Abdelkarim H. Omari, King Abdullah University Hospital
Carlos A. Ordonez, Universidad del Valle
José-Artur Paiva, University of Porto
Narayan D. Pant, Grande International Hospital
Jose G. Parreira, Santa Casa de Sao Paulo School of Medical Sciences
Michal Pędziwiatr, University Hospital Kraków
Bruno M. Pereira, University of Campinas
Alfredo Ponce-de-Leon, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán
Garyphallia Poulakou, Attikon University
Jacobus Preller, NHS Foundation Trust
Céline Pulcini, Lorraine University
Guntars Pupelis, Riga East University
Martha Quiodettis, Hospital Santo Tomas
Timothy M. Rawson, Imperial College London
Tarcisio Reis, Otavio de Freitas Hospital and Hosvaldo Cruz Hospital
Miran Rems, Jesenice General Hospital
Sandro Rizoli, University of Toronto
Jason Roberts, The University of Queensland
Nuno Rocha Pereira, São João Hospital Centre
Jesús Rodríguez-Baño, Universidad de Sevilla
Boris Sakakushev, University Hospital St George
James Sanders, JPS Health Network
Natalia Santos, Hospital Center Tondela Viseu
Norio Sato, Ehime University
Robert G. Sawyer, University of Virginia Health System
Sandro Scarpelini, University of Sao Paulo
Loredana Scoccia, Macerata Hospital
Nusrat Shafiq, Postgraduate Institute of Medical Education and Research
Vishalkumar Shelat, Tan Tock Seng Hospital
Costi D. Sifri, University of Virginia Health System
Boonying Siribumrungwong, Thammasat University
Kjetil Søreide, Stavanger University Hospital, University of Bergen
Rodolfo Soto, Centro Medico Imbanaco
Hamilton P. de Souza, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS)
Peep Talving, North Estonia Medical Center
Ngo Tat Trung, Tran Hung Dao Hospital
Jeffrey M. Tessier, John Peter Smith Health Network
Mario Tumbarello, Catholic University
Jan Ulrych, General University Hospital
Selman Uranues, Medical University of Graz
Harry Van Goor, Radboud University
Andras Vereczkei, University of Pécs
Florian Wagenlehner, edical Faculty of the Justus Liebig University Giessen
Yonghong Xiao, Zhejiang University
Kuo-Ching Yuan, Chang Gung Memorial Hospital
Agnes Wechsler-Fördös, Rudolfstiftung Hospital
Jean-Ralph Zahar, Angers University
Tanya L. Zakrison, University of Miami
Brian Zuckerbraun, University of Pittsburgh - Greensburg
Wietse P. Zuidema, VU University
Fausto Catena, Maggiore Hospital

Document Type

Article

Original Publication Date

2017

Journal/Book/Conference Title

World Journal of Emergency Surgery

Volume

12

Issue

34

First Page

1

Last Page

11

DOI of Original Publication

10.1186/s13017-017-0145-2

Comments

Originally published at https://doi.org/10.1186/s13017-017-0145-2

Date of Submission

August 2017

Abstract

Background

Antimicrobial Stewardship Programs (ASPs) have been promoted to optimize antimicrobial usage and patient outcomes, and to reduce the emergence of antimicrobial-resistant organisms. However, the best strategies for an ASP are not definitively established and are likely to vary based on local culture, policy, and routine clinical practice, and probably limited resources in middle-income countries. The aim of this study is to evaluate structures and resources of antimicrobial stewardship teams (ASTs) in surgical departments from different regions of the world.

Methods

A cross-sectional web-based survey was conducted in 2016 on 173 physicians who participated in the AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections) project and on 658 international experts in the fields of ASPs, infection control, and infections in surgery.

Results

The response rate was 19.4%. One hundred fifty-six (98.7%) participants stated their hospital had a multidisciplinary AST. The median number of physicians working inside the team was five [interquartile range 4–6]. An infectious disease specialist, a microbiologist and an infection control specialist were, respectively, present in 80.1, 76.3, and 67.9% of the ASTs. A surgeon was a component in 59.0% of cases and was significantly more likely to be present in university hospitals (89.5%, p < 0.05) compared to community teaching (83.3%) and community hospitals (66.7%). Protocols for pre-operative prophylaxis and for antimicrobial treatment of surgical infections were respectively implemented in 96.2 and 82.3% of the hospitals. The majority of the surgical departments implemented both persuasive and restrictive interventions (72.8%). The most common types of interventions in surgical departments were dissemination of educational materials (62.5%), expert approval (61.0%), audit and feedback (55.1%), educational outreach (53.7%), and compulsory order forms (51.5%).

Conclusion

The survey showed a heterogeneous organization of ASPs worldwide, demonstrating the necessity of a multidisciplinary and collaborative approach in the battle against antimicrobial resistance in surgical infections, and the importance of educational efforts towards this goal.

Rights

© The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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