192. Current Antimicrobial Stewardship Practices in Latin America: where are we? 
Session: Poster Abstract Session: Antimicrobial Stewardship: Current State and Future Opportunities
Thursday, October 8, 2015
Room: Poster Hall
  • 2015-09-29 AMS practices (final).pdf (221.0 kB)
  • Background: Antibiotic resistance is recognized as a major threat to public health worldwide. Antimicrobial stewardship (AMS) has shown to optimize antimicrobial use, curb antimicrobial resistance, improve clinical patient outcomes, and decrease healthcare costs. There is limited data about AMS practices in hospitals (hosp) in Latin America (LA). The purpose of this cross-sectional study was to describe the current AMS practices in hosp in LA.

    Methods: We conducted a 60-item survey adapted and modified from the 2014 CDC Checklist for Core Elements of Hospital AMS Programs. The survey was answered by one responsible clinician of the AMS activities in targeted hosp via email or Google forms between October 2014 and April 2015. Questions addressed leadership support, accountability and drug expertise, actions performed, tracking, reporting, and education on AMS. Data were summarized using descriptive statistics.

    Results: Twenty-seven respondents from 10 LA hosp completed the survey. Teaching hosp were 18 (66.7%). Several hosp did not have formal written statement supporting AMS (11/27, 40.7%). Fourteen (51.9%) hosp reported no information technology tools or training support for their AMS programs. Pharmacists were the least frequent (37%) professionals in the AMS teams. In the cases (14.8%) in which AMS was not leaded by an infectious disease physician, microbiologists or epidemiologists were in charge. Nine (33.3%) hosp failed to have recommendations based on local susceptibility for treatment of common clinical conditions. Also, antibiotic time-out audits after 48 h were not performed in 17 (63%) hosp and pre-authorization of specific antimicrobials was not required in 7 (25.9%). Automatic alerts for duplicative therapy and automatic stop for antibiotic orders were not performed in 25 (93%) and 17 (63%) hosp, respectively. Only seven (25.9%) laboratories agreed to perform and report confirmatory testing for multidrug-resistant organisms. Fifteen (55.6%) hosp monitor antibiotic consumption by Defined Daily Dose and in 11 (40.7%) some kind of education on AMS was performed.

    Conclusion: Our findings evidence that AMS activities are partially implemented in LA, especially because of the lack of multidisciplinary staff. Institutional support is required for further development and improvement of AMS programs.

    Juan Sebastian Muñoz, MD1, Gabriel Motoa, MD1, Kevin Escandón-Vargas, MD1, Luis Bavestrello, MD2, Rodolfo Quiros, MD3, Cristhian Hernandez, Bsc1, Christian Pallares, MD, MSc1 and Maria Virginia Villegas, MD, MSc, FIDSA1, (1)Bacterial Resistance and Hospital Epidemiology, Centro Internacional de Entrenamiento e Investigaciones Médicas (CIDEIM), Cali, Colombia, (2)Centro Médico Clínica Reñaca, Valparaíso, Chile, (3)Prevention and Control Infection Department, Hospital Universitario Austral, Buenos Aires, Argentina


    J. S. Muñoz, None

    G. Motoa, None

    K. Escandón-Vargas, None

    L. Bavestrello, None

    R. Quiros, None

    C. Hernandez, merck sharp & dohme: Consultant , Consulting fee

    C. Pallares, merck sharp & dohme: Consultant , Consulting fee

    M. V. Villegas, merck sharp & dohme: Consultant , Consulting fee and Research support

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 7th with the exception of research findings presented at the IDWeek press conferences.