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Optimising antimicrobial prescription in hospitals
by introducing an antimicrobial stewardship programme in Hong Kong:
consensus statement
PL Ho, JCF Cheng, PTY Ching,
JKC Kwan, WWL Lim, WCY Tong, TC Wu, CWS Tse, R Lam, R Yung, WH Seto;
Consensus Meeting Group on Antimicrobial Stewardship Programme
Subcommittee for Health Protection Programme on Antimicrobial Resistance,
Centre for Health Protection, Department of Health, Hong Kong
OBJECTIVE. To discuss the implementation of an ‘antimicrobial
stewardship programme’ as a means to improve the quality of
antimicrobial use in a hospital setting in Hong Kong.
PARTICIPANTS. Consensus working group on ‘antimicrobial
stewardship programme’, The Scientific Committee on Infection
Control, Centre for Health Protection, Department of Health, comprised
11 experts. The remit of the working
group was to discuss the rationale and requirement for optimising
antimicrobial prescriptions in hospitals by the introduction of
an ‘antimicrobial stewardship programme’.
EVIDENCE. PubMed articles, national and international
guidelines, and abstracts of international meetings published between
January 2000 and December 2004 on programmes for improving the use
of antimicrobials in hospitals. Only
English medical literature was reviewed.
CONSENSUS PROCESS. Data search was performed independently
by three members of the working group. They met on three occasions
before the meeting to discuss all collected articles. A final draft
was circulated to the working group before a meeting on 3 January
2005. Five commonly asked questions about an 'antimicrobial stewardship
programme’ were selected for discussion by the participants.
Published information on the rationale, components, outcome measures,
advantages, and disadvantages of the programme was reviewed. Recent
unpublished data from local studies of an ‘antimicrobial stewardship
programme’ were also discussed. The timing, potential problems,
and practical issues involved in the implementation of an ‘antimicrobial
stewardship programme’ in Hong Kong were then considered. The
consensus statement was circulated to and approved by all participants.
CONCLUSION. The continuous indiscriminate and excessive
use of antimicrobial agents promotes the emergence of antibiotic-resistant
organisms. Antimicrobial resistance substantially raises already-rising
health care costs and increases patient morbidity and mortality.
Pattern of prescriptions in hospitals can be improved through the
implementation of an ‘antimicrobial stewardship programme’.
A ‘universal’ and ‘continuous’ ‘antimicrobial
stewardship
programme’ should now be established in Hong Kong hospitals.
Hong Kong Med J 2006;12:141-8
Key words: Anti-bacterial agents; Cross infection;
Drug resistance, microbial; Hong Kong; Prescriptions, drug
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