Search

Background: Antimicrobial stewardship programs (ASPs) have been shown to reduce inappropriate antimicrobial use and its consequences. However, these programs lack legislative requirements in many places and it can be difficult to determine what human resources are required for these programs and how to create a business case to present to hospital administrators for program funding. The objectives of the current paper were to review legislative requirements and outline human resource requirements for ASPs, and to create a base business case for ASPs., Methods: A working group of antimicrobial stewardship experts from across Canada met to discuss the necessary components for creation of a business case for antimicrobial stewardship. A narrative review of the literature of the regulatory requirements and human resource recommendations for ASPs was conducted. Informed by the review and using a consensus decision-making process, the expert working group developed human resource recommendations based on a 1000 bed acute care health care facility in Canada. A spreadsheet based business case model for ASPs was also created., Results: Legislative and /or regulatory requirements for ASPs were found in 2 countries and one state jurisdiction. The literature review and consensus development process recommended the following minimum human resources complement: 1 physician, 3 pharmacists, 0.5 program administrative and coordination support, and 0.4 data analyst support as full time equivalents (FTEs) per 1000 acute care beds. Necessary components for the business case model, including the human resource requirements, were determined to create a spreadsheet based model., Conclusions: There is evidence to support the negative outcomes of inappropriate antimicrobial use as well as the benefits of ASPs. Legislative and /or regulatory requirements for ASPs are not common. The available evidence for human resource recommendations for ASPs using a narrative review process was examined and a base business case modelling scenario was created. As regulatory requirements for ASPs increase, it will be necessary to create accurate business cases for ASPs in order to obtain the necessary funding to render these programs successful., Competing Interests: Not applicable.Has been obtained by all authors.The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

A massive outbreak of a new Clostridium difficile clone affected the province of Quebec between 2002 and 2004. There are several theories as to the exact cause of the emergence of this new clone, including the overuse of some classes of antibiotics. Antibiotic prescription is associated with C. difficile-associated diarrhoea (CDAD), but which class has the highest risk is still the subject of debate. We analysed the global antibiotic consumption patterns in five institutions in Quebec, three in the area affected by the 2002-2004 CDAD outbreak and two in non-affected areas. We showed that there is no correlation between the type and amount of antibiotics used at the institution level and the magnitude of the outbreak. Deficient infection control measures likely led to the rapid spread and dissemination of this newly characterised clone within some parts of Quebec.