PAHO develops a tool to support the evaluation of countries' Antimicrobial Stewardship Programs

20 Apr 2022
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Washington DC, 18 April 2022 (PAHO) - The Pan American Health Organization (PAHO) has developed a tool to evaluate Antimicrobial Stewardship (AMS) Programs in hospitals, which includes additional indicators to those proposed in the World Health Organization's (WHO) tool.

The tool will help countries and health facilities determine their level of preparedness for optimizing antimicrobial use at the institutional level. It will also help hospitals gradually design a plan of action and facilitate monitoring of progress in the implementation of programs and optimization measures.

The monitoring tool facilitates the assessment of the quality, efficacy, coverage, and delivery of comprehensive measures to optimize antimicrobial use, as well as any necessary adjustments in a continuous quality improvement cycle. 

To build the tool, PAHO used a modified Delphi method to achieve a structured consensus, facilitating equitable participation and collaboration from the invited experts. A set of complementary indicators was evaluated which were obtained from the review of existing tools.

Participatory rounds were held in which a set of indicators was reorganized and modified. In the end, 36 were maintained in addition to the 41 WHO indicators, for a total of 77.

This tool will be included in RedCap as a registration platform. Finally, it will be validated through a prospective pilot study in a set of hospitals, correlating the level of development of their AMS program with antimicrobial use indicators, as well as impact indicators.

The tool for evaluating AMS programs in hospitals is aimed at managers and directors of health facilities, committees and teams for optimizing antimicrobial use, and leaders responsible for the general coordination and implementation of AMS programs in these institutions. 

In both inpatient and outpatient settings, AMS programs are among the responses aimed at containing the emergence of antimicrobial resistance. They offer a cost-effective and safe way to improve clinical outcomes in patients who receive antimicrobials, extending the shelf life of these medicines by reducing the emergence of resistance.

This initiative is part of the project "Working together to fight antimicrobial resistance", implemented with support from the European Union, in collaboration with the Food and Agriculture Organization of the United Nations (FAO) and the World Organization for Animal Health (OIE).