Current state of antimicrobial stewardship and organ transplantation in Thailand

Background: Antimicrobial stewardship (AMS) is a coherent set of actions to optimize antimicrobial use, improve patient outcomes, and reduce antimicrobial resistance (AMR). Thailand's national strategic plan has included AMS since 2017. Due to an increased risk of infection and AMR, solid organ...

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Main Author: Chotiprasitsakul D.
Other Authors: Mahidol University
Format: Article
Published: 2023
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Online Access:https://repository.li.mahidol.ac.th/handle/123456789/87227
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spelling th-mahidol.872272023-06-20T12:24:59Z Current state of antimicrobial stewardship and organ transplantation in Thailand Chotiprasitsakul D. Mahidol University Medicine Background: Antimicrobial stewardship (AMS) is a coherent set of actions to optimize antimicrobial use, improve patient outcomes, and reduce antimicrobial resistance (AMR). Thailand's national strategic plan has included AMS since 2017. Due to an increased risk of infection and AMR, solid organ transplant (SOT) recipients can benefit from antimicrobial stewardship programs (ASPs). However, the AMS in SOT has not been well defined. Balancing ASPs with the need for early and frequent antimicrobial treatment in this population is challenging. This review assesses the barriers and potential strategies of AMS in SOT in the setting of Thailand. Methods: We used PubMed to identify published articles on AMS in organ transplantation in Thailand from January 2013 to January 2022. We also searched local literature and local data from Google Scholar and Google. Finally, we described the AMS experience at Ramathibodi hospital as a proxy for transplant centers in Thailand. Results: There was no specific article on AMS in SOT in Thailand. At our hospital, ASPs have been part of the hospital's routine patient care, including the practice in the transplant unit. Modifiable challenges to AMS in SOT include prescriber opposition, diagnosis uncertainty, and lack of high quality. Both systems and individualized approaches should be implemented to overcome these barriers. The potential interventions include shortening antibiotic time-out, updating clinical guidelines, continuing education, handshake ASP, adopting new technology, and further research. Conclusions: There are limited data on AMS in organ transplantation in Thailand. Strategic priorities should focus on modifiable barriers tailored to organ transplantation. Quality improvement should be ensured by process and outcome measures. 2023-06-20T05:24:59Z 2023-06-20T05:24:59Z 2022-10-01 Article Transplant Infectious Disease Vol.24 No.5 (2022) 10.1111/tid.13877 13993062 13982273 36254509 2-s2.0-85139968707 https://repository.li.mahidol.ac.th/handle/123456789/87227 SCOPUS
institution Mahidol University
building Mahidol University Library
continent Asia
country Thailand
Thailand
content_provider Mahidol University Library
collection Mahidol University Institutional Repository
topic Medicine
spellingShingle Medicine
Chotiprasitsakul D.
Current state of antimicrobial stewardship and organ transplantation in Thailand
description Background: Antimicrobial stewardship (AMS) is a coherent set of actions to optimize antimicrobial use, improve patient outcomes, and reduce antimicrobial resistance (AMR). Thailand's national strategic plan has included AMS since 2017. Due to an increased risk of infection and AMR, solid organ transplant (SOT) recipients can benefit from antimicrobial stewardship programs (ASPs). However, the AMS in SOT has not been well defined. Balancing ASPs with the need for early and frequent antimicrobial treatment in this population is challenging. This review assesses the barriers and potential strategies of AMS in SOT in the setting of Thailand. Methods: We used PubMed to identify published articles on AMS in organ transplantation in Thailand from January 2013 to January 2022. We also searched local literature and local data from Google Scholar and Google. Finally, we described the AMS experience at Ramathibodi hospital as a proxy for transplant centers in Thailand. Results: There was no specific article on AMS in SOT in Thailand. At our hospital, ASPs have been part of the hospital's routine patient care, including the practice in the transplant unit. Modifiable challenges to AMS in SOT include prescriber opposition, diagnosis uncertainty, and lack of high quality. Both systems and individualized approaches should be implemented to overcome these barriers. The potential interventions include shortening antibiotic time-out, updating clinical guidelines, continuing education, handshake ASP, adopting new technology, and further research. Conclusions: There are limited data on AMS in organ transplantation in Thailand. Strategic priorities should focus on modifiable barriers tailored to organ transplantation. Quality improvement should be ensured by process and outcome measures.
author2 Mahidol University
author_facet Mahidol University
Chotiprasitsakul D.
format Article
author Chotiprasitsakul D.
author_sort Chotiprasitsakul D.
title Current state of antimicrobial stewardship and organ transplantation in Thailand
title_short Current state of antimicrobial stewardship and organ transplantation in Thailand
title_full Current state of antimicrobial stewardship and organ transplantation in Thailand
title_fullStr Current state of antimicrobial stewardship and organ transplantation in Thailand
title_full_unstemmed Current state of antimicrobial stewardship and organ transplantation in Thailand
title_sort current state of antimicrobial stewardship and organ transplantation in thailand
publishDate 2023
url https://repository.li.mahidol.ac.th/handle/123456789/87227
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