[Monitoring activities and improvement in the use of antibiotics in Spanish hospitals: results of a national survey].
OBJECTIVE
To describe: 1) the main features of antimicrobial stewardship activities (ASA) in Spanish hospitals and 2) the perceptions of the Spanish Infectious Diseases (ID) community on ASA.


METHODS
An online survey was designed and distributed through the e-mailing lists of several working groups of the Spanish Clinical Microbiology and Infectious Diseases Society.


RESULTS
Between September 15 and November 23, 2009, surveys representing 78 hospitals were received. Most of the respondents were either ID physicians (30%) or microbiologists (29%), and 31/78 hospitals (40%) had ongoing ASA. These hospitals were concentrated in 4 of the 17 regions, particularly in Catalonia. Professionals belonging to 26/31 centres with ASA completed the survey. The most frequent principles of antibiotic (ABX) stewardship implemented in these programs were: 1) ABX streamlining (22/26) and 2) intravenous to oral switch (22/26) followed by 3) strategic monitoring of ABX (21/26). In 22/26 (86%) of the centres with ASA any physician could initially prescribe any of the antimicrobials included in the formulary. The most frequent activity carried out was ABX restriction, 69% (18/26) followed by conferences 61% (16/26) and therapeutic audit and feed-back 54% (14/26). When asked which antimicrobials that should be closely monitored, carbapenems were considered by all respondents in centres with ongoing ASA.


CONCLUSIONS
1) A minority (40%) of the surveyed hospitals in Spain has an ongoing ASA and large geographical variations were observed. 2) ASA were most commonly structured in the form of an integrated part-time multidisciplinary team of ID physicians and Pharmacists, and 3) Carbapenems were considered the ABX most required to be monitored.
Unidad de Enfermedades Infecciosas, Hospital Universitario La Paz-IDIPAZ, Madrid, España. jrpano.hulp@salud.madrid.org
José Ramón
JR
Paño-Pardo
Belén
B
Padilla
María Pilar
MP
Romero-Gómez
Francisco
F
Moreno-Ramos
Alicia
A
Rico-Nieto
Marta
M
Mora-Rillo
Juan Pablo
JP
Horcajada
José
J
Ramón Arribas
Jesús
J
Rodríguez-Baño
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003625:Data Collection; D004363:Drug Utilization / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D010607:Pharmacy Service, Hospital / Q000706:statistics & numerical data*; D013030:Spain
D000900:Anti-Bacterial Agents