title: Assessment of Antimicrobial Stewardship Activities in a Large Metropolitan Area.
abstract: OBJECTIVE
  To describe antimicrobial stewardship programs (ASPs) of acute and long-term acute care (LTAC) hospitals in Houston, Texas.
  
  
  METHODS
  Two-part survey to clinical pharmacists and pharmacy directors. All acute care and LTAC facilities from the Harris County Medical Society database were invited to participate.
  
  
  RESULTS
  In part 1 of the telephone survey, 82 facilities within Houston, Harris county, were contacted by telephone of which 51 responded (response rate: 62%). Of respondents, 55% (n = 28) reported having an active ASP and 8% (n = 4) planned implementation within 12 months. Acute care and LTAC hospitals reported ASPs in 57% and 67% of facilities, respectively. Physician champions were involved in 71% (n = 20) of active ASPs; clinical pharmacists were involved in 75% (n = 21) of programs. In part II, 22 (43%) facilities completed the online survey; postprescription review with feedback was used in facilities with an ASP and medical training program (5 of 5) while formulary restriction was in facilities without stewardship or medical training (6 of 8).
  
  
  CONCLUSIONS
  This is the first major survey of ASP in a major metropolitan area. The stewardship effort in the city of Houston is encouraging; we expect the number of stewardship programs in all facilities will continue to rise as focus on antimicrobial resistance grows.
authors.affiliation: CPL Associates, LLC, Buffalo, NY, USA Department of Pharmacy Practice, University at Buffalo School of Pharmacy and Pharmaceutical Sciences, Buffalo, NY, USA dmjacobs@buffalo.edu.
authors.forename: David M
authors.initials: DM
authors.lastname: Jacobs
authors.affiliation: VHA Performance Services, Houston, TX, USA.
authors.forename: Kristi
authors.initials: K
authors.lastname: Kuper
authors.affiliation: Clinical Service Group, HCA Nashville, Nashville, TN, USA and Department of Internal Medicine, Texas A&M Health Science Center, Houston, TX, USA.
authors.forename: Edward
authors.initials: E
authors.lastname: Septimus
authors.affiliation: Houston Department of Health and Human Services, Houston, TX, USA.
authors.forename: Raouf
authors.initials: R
authors.lastname: Arafat
authors.affiliation: Department of Clinical Sciences and Administration, University of Houston College of Pharmacy, Houston TX, USA.
authors.forename: Kevin W
authors.initials: KW
authors.lastname: Garey
mesh_terms: D000890:Anti-Infective Agents / Q000009:adverse effects / Q000627:therapeutic use*; D019538:Health Care Surveys / Q000379:methods / Q000592:standards*; D006786:Hospitals, Urban / Q000592:standards*; D006801:Humans; D010595:Pharmacists / Q000592:standards*; D013781:Texas / Q000453:epidemiology; D014505:Urban Population
chemical_list: D000890:Anti-Infective Agents
keywords: anti-infectives; antimicrobial stewardship; regional survey