A national antimicrobial surveillance: perspective of a mother-child teaching institution 1
Roy H , Ovetchkine P², Bussières JF 1
1,3
Département de pharmacie et Unité de Recherche en Pratique Pharmaceutique (URPP), CHU Sainte-Justine, Montréal 2 Département de pédiatrie, CHU Sainte-Justine, Montréal 3 Faculté de pharmacie, Université de Montréal, Montréal
INTRODUCTION Health-acquired infections are well known, common and costly: catheter-related bloodstream infection, ventilator-associated pneumonia, surgical site infection and catheter-associated urinary tract infection Infection rates of multidrug-resistant organisms are increasing in Canada In the context of a 2010-2015 ministerial action plan for the prevention and control of nosocomial infections, a national antimicrobial surveillance program was implemented in Quebec starting April 1st, 2012 OBJECTIVES Describe the perspective of a mother-child teaching hospital with the implementation of a national antimicrobial surveillance program Describe the organization and the action plan implemented at the hospital level SETTING
DESIGN
Mother and Child University Hospital Center Sainte-Justine (CHUSJ)
Descriptive study RESULTS
A.P.E.S « Association des pharmaciens des établissements de santé du Québec » Infectious disease group of experts RPE: « Regroupement de pharmaciens experts en infectiologie »
Pharmacological and Therapeutic Committee at CHUSJ
Antimicrobial surveillance committee (ASC): Infection Control Committee at CHUSJ
CRUAM « Comité de revue d’utilisation des antimicrobiens» at CHUSJ Team: 4 pharmacists and 2 physicians Legend :
: reports to
: collaborates
10 key priorities for 2012-2013 1
To establish the operating mode of the committee (composition, frequency of meetings, interactions with Pharmacological and Therapeutic committee, dissemination of information, etc.)
2
To search the scientific literature on quantitative evaluation of pediatric antimicrobial agents and on antimicrobial stewardship To develop the tools for periodical quantitative assessment/monitoring of antimicrobial consumption:
3
defined daily dose (DDD) in the pharmacy information system to publish a periodical report of DDD per 1000 patient-days days of therapy (DOT) globally and per agent mean mg/kg dose for antimicrobial surveillance, per ward, monthly
4
To review the indications of the restricted antimicrobial agents and the ways to apply monitoring
5
To conduct drug utilization reviews of broad-spectrum antimicrobial agents commonly used
6
To meet periodically the various healthcare teams for information, feedback and targeted action (e.g. to handle current and expected drug shortages)
7
To meet outstanding demands of healthcare teams
8
To introduce the use of once-daily tobramycin in the treatment of cystic fibrosis
9
To introduce a new vancomycin dosing regimen in neonatology
10
To evaluate levofloxacin for possible addition to the hospital formulary
DISCUSSION While decentralized pharmaceutical care contribute to optimal use of antimicrobial in hospital, a transversal antimicrobial surveillance committee is necessary and in line with the concept of antimicrobial stewardship; this committee is also supportting decentralized pharmacists offering pharmaceutical care to inpatient and outpatient CONCLUSION A national antimicrobial surveillance program is being implemented in Quebec This descriptive study illustrates the activity of a local antimicrobial surveillance committee Contact:
[email protected] — Acknowledgements to Alexia Schott for the creation of this poster
