Optimizing Antibiotic Stewardship in United Arab Emirates Hospitals: An Assessment of Programme Structure in Emirates Health Services.

IF 3.1 3区医学 Q1 INFECTIOUS DISEASES

Journal of Hospital Infection Pub Date : 2025-10-09 DOI:10.1016/j.jhin.2025.09.002

Fatma Al Hamidh, Md Hafizur Rahman, Esmita Charani

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引用次数: 0

Abstract

Background: Optimal implementation of Antibiotic Stewardship Programmes (ASPs) is crucial to combat antibiotic resistance in gulf countries including the United Arab Emirates (UAE). This study evaluates ASP structure in UAE hospitals for seven core elements defined by Centres for Disease Control and Prevention (CDC) and World Health Organisation (WHO).

Methods: A mixed-methods approach across 12 Emirates Health Services (EHS) hospitals, included document reviews, surveys, and expert interviews. Document evaluation was performed on a 3-point Likert scale. Online surveys distributed to a random sample of 385 employees, evaluated ASP dissemination using a 5-point Likert scale, analysed descriptively and through Mann-Whitney and Kruskal-Wallis tests (P<0.05) using SPSS. Interviews with programme experts were thematically analysed using NVIVO.

Results: Document analysis showed 6 of 7 ASP core elements fully met, with accountability partially met in all hospitals. The survey (83% response rate) revealed partial ASP dissemination (median = 4, IQR=2) across all elements, with significant differences between employee groups and hospitals (P=0.032). Interviews with 12 ASP experts identified key programme facilitators to be leadership, active interventions, pharmacist engagement, and tailored education. Barriers were inconsistent antibiotic tracking, physician resistance, lack of rapid diagnostics, competency framework and cadre training.

Conclusion: EHS ASP demonstrates adequate structure but inconsistent dissemination across hospitals. This first UAE mixed-methods study benchmarks local ASP against CDC and WHO standards, aligning with high-income countries but diverging from practices in Middle East and North African countries. ASP implementation and adoption optimisation needs to be explored with process and outcome indicator data focusing on prescribing, cost-effectiveness and clinical outcomes.

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优化抗生素管理在阿拉伯联合酋长国医院：在阿联酋卫生服务方案结构的评估。

背景：优化实施抗生素管理规划（asp）对于包括阿拉伯联合酋长国（UAE）在内的海湾国家抗击抗生素耐药性至关重要。本研究评估了由疾病控制和预防中心（CDC）和世界卫生组织（WHO）定义的阿联酋医院ASP结构的七个核心要素。方法：对12家阿联酋卫生服务（EHS）医院采用混合方法，包括文献回顾、调查和专家访谈。文献评价采用3点李克特量表。通过对385名员工随机抽样的在线调查，采用5点李克特量表评估ASP的传播，并通过曼-惠特尼和克鲁斯卡尔-沃利斯测试进行描述性分析(结果：文献分析显示，所有医院都完全满足ASP的7个核心要素中的6个，部分满足问责制。调查（83%的回复率）显示ASP在所有要素中都有部分传播（中位数= 4，IQR=2），员工群体和医院之间存在显著差异（P=0.032）。与12名ASP专家的访谈确定了关键的规划促进因素是领导力、积极干预、药剂师参与和量身定制的教育。障碍是不一致的抗生素追踪、医生耐药性、缺乏快速诊断、能力框架和干部培训。结论：EHS ASP结构合理，但在医院间传播不一致。这是阿联酋首个混合方法研究，将当地ASP与CDC和世卫组织的标准进行对比，与高收入国家保持一致，但与中东和北非国家的做法有所不同。ASP的实施和采用优化需要通过侧重于处方、成本效益和临床结果的过程和结果指标数据进行探索。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Hospital Infection 医学-传染病学

CiteScore

12.70

自引率

5.80%

发文量

271

审稿时长

19 days

期刊介绍： The Journal of Hospital Infection is the editorially independent scientific publication of the Healthcare Infection Society. The aim of the Journal is to publish high quality research and information relating to infection prevention and control that is relevant to an international audience. The Journal welcomes submissions that relate to all aspects of infection prevention and control in healthcare settings. This includes submissions that: provide new insight into the epidemiology, surveillance, or prevention and control of healthcare-associated infections and antimicrobial resistance in healthcare settings; provide new insight into cleaning, disinfection and decontamination; provide new insight into the design of healthcare premises; describe novel aspects of outbreaks of infection; throw light on techniques for effective antimicrobial stewardship; describe novel techniques (laboratory-based or point of care) for the detection of infection or antimicrobial resistance in the healthcare setting, particularly if these can be used to facilitate infection prevention and control; improve understanding of the motivations of safe healthcare behaviour, or describe techniques for achieving behavioural and cultural change; improve understanding of the use of IT systems in infection surveillance and prevention and control.