PMID- 29339297
OWN - NLM
STAT- MEDLINE
DCOM- 20181011
LR  - 20181011
IS  - 1872-7913 (Electronic)
IS  - 0924-8579 (Linking)
VI  - 51
IP  - 6
DP  - 2018 Jun
TI  - Experiences and perspectives of implementing antimicrobial stewardship in five
      French hospitals: a qualitative study.
PG  - 829-835
LID - S0924-8579(18)30005-0 [pii]
LID - 10.1016/j.ijantimicag.2018.01.002 [doi]
AB  - The aim of this study was to describe current antimicrobial stewardship
      programmes (ASPs) in France, both at policy level and at local implementation
      level, and to assess how ASP leaders (ASPL) worked and prioritised their
      activities. A qualitative study based on face-to-face semi-structured interviews 
      with healthcare professionals responsible for ASPs across five French hospitals
      was conducted. Five infectious diseases specialists and one microbiologist were
      interviewed between April-June 2016. Stewards had dedicated time to perform ASP
      activities in two university-affiliated hospitals, whilst in the other hospitals 
      (one university, one general and one semi-private), ASPLs had to balance these
      activities with clinical practice. Consequently, they had to adapt interventions 
      according to their resources (IT or human). Responding to colleagues'
      consultation requests formed baseline work. Systematic and pro-active measures
      allowed for provision of unsolicited counselling, whilst direct counselling on
      wards required appropriate staffing. ASPLs aimed at increasing clinicians'
      ability to prescribe adequately and awareness of the unintended consequences of
      inappropriate use of antibiotics. Thus, persuasive, e.g. education, measures were
      preferred to coercive ones. ASPLs faced several challenges in implementing the
      ASP: overcoming physicians' or units' reluctance; and balancing the influence of 
      medical hierarchy and professional boundaries. Beyond resources constraints,
      ASPLs' conceptions of their work, as well as contextual and cultural aspects, led
      them to adopt a persuasive and collaborative approach of counselling. This is the
      first qualitative study regarding ASPs in France exploring stewards' experiences 
      and points of view.
CI  - Copyright (c) 2018 Elsevier B.V. and International Society of Chemotherapy. All
      rights reserved.
FAU - Perozziello, Anne
AU  - Perozziello A
AD  - IAME, UMR 1137, DeSCID Team, Universite Paris Diderot, Sorbonne Paris Cite,
      Paris, France. Electronic address: anne.perozziello@aphp.fr.
FAU - Routelous, Christelle
AU  - Routelous C
AD  - Institut du Management/EA 7348 MOS Management des organisations en sante, Ecole
      des hautes etudes en sante publique, EHESP, Rennes Sorbonne Paris Cite, Paris,
      France.
FAU - Charani, Esmita
AU  - Charani E
AD  - NIHR Health Protection Research Unit in Antimicrobial Resistance and Healthcare
      Associated Infection, Imperial College London, Department of Medicine, London,
      UK.
FAU - Truel, Alice
AU  - Truel A
AD  - IAME, UMR 1137, DeSCID Team, Universite Paris Diderot, Sorbonne Paris Cite,
      Paris, France.
FAU - Birgand, Gabriel
AU  - Birgand G
AD  - Health Protection Research Unit in Healthcare Associated Infections and
      Antimicrobial Resistance, Imperial College London, London, UK.
FAU - Yazdanpanah, Yazdan
AU  - Yazdanpanah Y
AD  - IAME, UMR 1137, DeSCID Team, Universite Paris Diderot, Sorbonne Paris Cite,
      Paris, France; Service de Maladies Infectieuses et Tropicales, Hopital
      Bichat-Claude Bernard, AP-HP, Paris, France.
FAU - Lescure, Francois-Xavier
AU  - Lescure FX
AD  - IAME, UMR 1137, DeSCID Team, Universite Paris Diderot, Sorbonne Paris Cite,
      Paris, France; Service de Maladies Infectieuses et Tropicales, Hopital
      Bichat-Claude Bernard, AP-HP, Paris, France.
FAU - Lucet, Jean-Christophe
AU  - Lucet JC
AD  - IAME, UMR 1137, DeSCID Team, Universite Paris Diderot, Sorbonne Paris Cite,
      Paris, France; Unite d'Hygiene et de Lutte contre les Infections Nosocomiales
      (UHLIN), Hopital Bichat-Claude Bernard, AP-HP, Paris, France.
CN  - CEFECA Study Group
LA  - eng
PT  - Journal Article
DEP - 20180112
PL  - Netherlands
TA  - Int J Antimicrob Agents
JT  - International journal of antimicrobial agents
JID - 9111860
RN  - 0 (Anti-Bacterial Agents)
SB  - IM
MH  - Anti-Bacterial Agents/*therapeutic use
MH  - Antimicrobial Stewardship/*methods
MH  - Drug Resistance, Multiple, Bacterial
MH  - France
MH  - Hospitals
MH  - Humans
MH  - Physicians
MH  - *Practice Patterns, Physicians'
MH  - Surveys and Questionnaires
OTO - NOTNLM
OT  - Antibiotics
OT  - Antimicrobial resistance
OT  - Antimicrobial stewardship
OT  - Qualitative study
IR  - Burdet C
FIR - Burdet, Charles
IRAD- INSERM U1137, Paris.
IR  - Kardas L
FIR - Kardas, Lidia
IRAD- INSERM U1137, Paris.
IR  - Lepeule R
FIR - Lepeule, Raphael
IRAD- Hopital Henri Mondor, AP-HP, Creteil.
IR  - Lesprit P
FIR - Lesprit, Philippe
IRAD- Hopital Foch, Suresnes.
IR  - L'Heriteau F
FIR - L'Heriteau, Francois
IRAD- CCLIN Paris Nord, Paris.
IR  - Luong Nguyen LB
FIR - Luong Nguyen, Liem-Binh
IRAD- Hopital Bichat, AP-HP, Paris.
IR  - Mourvillier B
FIR - Mourvillier, Bruno
IRAD- Hopital Bichat, AP-HP, Paris.
IR  - Vaillant L
FIR - Vaillant, Laetitia
IRAD- Hopital Bichat, AP-HP, Paris.
IR  - Zahar JR
FIR - Zahar, Jean-Ralph
IRAD- Hopital Avicenne, AP-HP, Bobigny.
EDAT- 2018/01/18 06:00
MHDA- 2018/10/12 06:00
CRDT- 2018/01/18 06:00
PHST- 2017/09/13 00:00 [received]
PHST- 2017/11/27 00:00 [revised]
PHST- 2018/01/06 00:00 [accepted]
PHST- 2018/01/18 06:00 [pubmed]
PHST- 2018/10/12 06:00 [medline]
PHST- 2018/01/18 06:00 [entrez]
AID - S0924-8579(18)30005-0 [pii]
AID - 10.1016/j.ijantimicag.2018.01.002 [doi]
PST - ppublish
SO  - Int J Antimicrob Agents. 2018 Jun;51(6):829-835. doi:
      10.1016/j.ijantimicag.2018.01.002. Epub 2018 Jan 12.