Antimicrobial resistance is a recognised threat to modern medicine,1 and is a growing concern in New Zealand.2 Antimicrobial stewardship (AMS), a collection of co-ordinated strategies that aims to optimise the…
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Antimicrobial resistance is a growing problem in New Zealand and means that antimicrobials are becoming less effective. Antimicrobial stewardship (co-ordinated strategies to help optimise the use of antimicrobials) can slow the progression of resistance. This survey shows that antimicrobial stewardship is in its infancy in New Zealand’s public hospitals, with only around half of our DHBs employing dedicated pharmacists and doctors to help optimise antimicrobial prescribing. Practices to improve antimicrobial prescribing (eg, audit, teaching, guideline development) are highly variable from DHB to DHB. National co-ordination is needed to help DHBs develop effective programmes to help preserve antimicrobials for future use.
To determine what antimicrobial stewardship (AMS) practices exist in New Zealand public hospitals.
A quantitative survey based on recommended components of hospital AMS programmes was sent to the 20 DHBs in June 2016.
Ten of the 20 DHBs had an AMS committee, nine had dedicated AMS pharmacist full-time equivalents (FTEs) and eight had lead clinician FTEs. Only one DHB met FTE recommendations for AMS pharmacists and two for clinicians (0.3 and 0.1 FTEs per 100 acute beds, respectively). All DHBs had conducted at least one antimicrobial audit in the preceding 12 months, most had their own antimicrobial guidelines (19/20) and prescribing policies (18/20), and 12 reported on antimicrobial usage by at least one metric (eg, defined daily doses). Staff education on AMS had been given at most DHBs in the previous year, but only three reported having AMS ward rounds. All DHBs had surveillance programmes for resistant organisms and most produced antibiograms (16/20). All reported barriers to implementation of an AMS programme.
Hospital AMS programmes are in their infancy in New Zealand, with wide variation in practices seen. National co-ordination is required to assist DHBs in developing effective programmes to improve antimicrobial use.