Key points
- Coordinated efforts to improve the use of antibiotics, called antibiotic stewardship, are key to combating antimicrobial resistance (AR).
- CDC and partners developed a tool to help global inpatient healthcare facilities evaluate their antibiotic stewardship practices.
- More than 80 healthcare facilities across 12 low- to middle-income countries have used the tool to advance their antibiotic stewardship practices.
Stewardship is key to combating AR
CDC's International Infection Control Branch (IICB), in collaboration with Johns Hopkins University, University of Oxford with Duke University consultants, and the University of Pennsylvania, developed a Global Antibiotic Stewardship Evaluation Tool (G-ASET) to help inpatient healthcare facilities assess their antibiotic stewardship practices.
Antibiotic stewardship refers to coordinated efforts and activities to improve the appropriate use of antibiotics. Implementing antibiotic stewardship programs is one of the key components of WHO's Global Action Plan to combat AR and is an important part of U.S. National Action Plan for Combating Antibiotic-resistant Bacteria.
Not a one-size-fits-all approach
To help facilities prioritize stewardship actions that fit their facility's specific needs and resources, CDC and partners developed the G-ASET.
Developing the tool
A multidisciplinary group of physicians, pharmacists, microbiologists, and researchers from government and academic institutions collaborated to develop the tool.
They used a comprehensive multi-step process that emphasized clinical relevancy and feasibility and pulled from existing literature and resources such as CDC's Core Elements of Antibiotic Stewardship Programs, WHO's Antimicrobial Stewardship Toolkit, and WHO Policy Guidance.
The result was the G-ASET, a tool that helps facilities identify opportunities to improve antibiotic stewardship programs by assessing:
- Leadership commitment and accountability
- Resources
- Education and training
- Antibiotic stewardship actions
- Antibiotic use tracking, monitoring, and reporting
Facilities are encouraged to assess their programs using the G-ASET at least annually to monitor progress over time.
Implementation
A small number of inpatient healthcare facilities around the world initially piloted the G-ASET.
Implementation across 12 countries
The G-ASET will help these facilities advance their antibiotic stewardship practices. For example, some participating facilities are using the findings from the G-ASET to help develop new infectious diseases treatment guidelines and improve existing ones.
As IICB works to develop and advance sustainable antibiotic stewardship programs across the globe, the G-ASET is an important resource for inpatient healthcare facilities to achieve this goal.
- Nilsen P, Bernhardsson S. Context matters in implementation science: a scoping review of determinant frameworks that describe contextual determinants for implementation outcomes. BMC Health Serv Res 2019;19(1):189. doi: 10.1186/s12913-019-4015-3