title: Selective reporting of antibiotic susceptibility test results in European countries: an ESCMID cross-sectional survey.
abstract: Selective reporting of antibiotic susceptibility test (AST) results is one possible laboratory-based antibiotic stewardship intervention. The primary aim of this study was to identify where and how selective reporting of AST results is implemented in Europe both in inpatient and in outpatient settings. An ESCMID cross-sectional, self-administered, internet-based survey was conducted among all EUCIC (European Committee on Infection Control) or EUCAST (European Committee on Antimicrobial Susceptibility Testing) national representatives in Europe and Israel. Of 38 countries, 36 chose to participate in the survey. Selective reporting of AST results was implemented in 11/36 countries (31%), was partially implemented in 4/36 (11%) and was limited to local initiatives or was not adopted in 21/36 (58%). It was endorsed as standard of care by health authorities in only three countries. The organisation of selective reporting was everywhere discretionally managed by each laboratory, with a pronounced intra- and inter-country variability. The most frequent application was in uncomplicated community-acquired infections, particularly urinary tract and skin and soft-tissue infections. The list of reported antibiotics ranged from a few first-line options, to longer reports where only last-resort antibiotics were hidden. Several barriers to implementation were reported, mainly lack of guidelines, poor system support, insufficient resources, and lack of professionals' capability. In conclusion, selective reporting of AST results is poorly implemented in Europe and is applied with a huge heterogeneity of practices. Development of an international framework, based on existing initiatives and identified barriers, could favour its dissemination as one important element of antibiotic stewardship programmes.
authors.affiliation: Université de Lorraine, EA 4360 APEMAC, Nancy, France; Service de Maladies infectieuses et Tropicales, CHRU de Nancy, Nancy, France. Electronic address: celine.pulcini@univ-lorraine.fr.
authors.forename: Céline
authors.initials: C
authors.lastname: Pulcini
authors.affiliation: Université de Lorraine, EA 4360 APEMAC, Nancy, France.
authors.forename: Gianpiero
authors.initials: G
authors.lastname: Tebano
authors.affiliation: Department of Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany.
authors.forename: Nico T
authors.initials: NT
authors.lastname: Mutters
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine I, Tübingen University Hospital, Tübingen, Germany; German Centre for Infection Research (DZIF), Tübingen, Germany.
authors.forename: Evelina
authors.initials: E
authors.lastname: Tacconelli
authors.affiliation: AP-HP, Hôpital Lariboisière, Service de Bactériologie, Université Paris Diderot, Sorbonne Paris Cité, Paris, France; UMR 1137, INSERM IAME, Paris, France.
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Cambau
authors.affiliation: Central Hospital, Department of Clinical Microbiology, Växjö, Sweden.
authors.forename: Gunnar
authors.initials: G
authors.lastname: Kahlmeter
authors.affiliation: AP-HP, Hôpital Pitié-Salpêtrière, Bactériologie-Hygiène, Sorbonne Universités, Université Pierre et Marie Curie (Université de Paris 6), Paris, France; INSERM U1135, Centre for Immunology and Microbial Infections, Team 13, Paris, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Jarlier
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D004363:Drug Utilization / Q000592:standards*; D005060:Europe; D019983:Guideline Adherence; D006801:Humans; D007557:Israel; D008826:Microbial Sensitivity Tests / Q000379:methods*
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibiotic prescription; Antibiotic resistance; Antibiotic stewardship; Antibiotic susceptibility testing; Questionnaire; Selective reporting