PDF(Pubmed)
Abstract：
As antimicrobial resistance (AMR) represents a substantial threat to the efficacy of available antimicrobial options, it is important to understand how to implement effective and practical mitigation efforts, including antimicrobial stewardship (AMS), across human, animal, and environmental sectors.
A mixed-methods questionnaire was distributed virtually to attendees of the virtual One Health Antimicrobial Stewardship Conference (March 10-12, 2021) and their professional networks. Respondents (n = 81) were largely from the veterinary (75%) or human (19%) health sectors. Qualitative data were analyzed in NVivo using template analysis whereas quantitative data were analyzed in STATA using Kruskall-Wallis tests. The questionnaire asked respondents about their perceptions of AMS, as well as the perceived barriers and drivers of AMS efforts.
Perceptions of what AMS meant to the respondents personally and their profession as a whole were grouped into 3 main themes: 1) AMS strategies or considerations in antimicrobial prescribing and use; 2) responsibility to maintain health and preserve antimicrobial effectiveness; and 3) reducing antimicrobial use (AMU) as a goal of AMS efforts. Identified AMS barriers had 3 main themes: 1) lack of various prescribing and AMU support mechanisms; 2) shift in prescriber attitudes to drive change; and 3) stronger economic considerations to support shifting prescribing practices. Drivers of AMS had the following themes: 1) leadership to guide change; 2) education to support optimizing AMU; and 3) research to identify best practices and opportunities for action. Across all questions, 2 cross-cutting themes emerged: 1) a One Health understanding of AMS; and 2) blame placed on others for a lack of AMS success.
Overall, sector-specific, but particularly cross-sectoral AMS drivers and barriers were identified, highlighting the importance of a One Health approach in AMR research and mitigation.
A mixed-methods questionnaire was distributed virtually to attendees of the virtual One Health Antimicrobial Stewardship Conference (March 10-12, 2021) and their professional networks. Respondents (n = 81) were largely from the veterinary (75%) or human (19%) health sectors. Qualitative data were analyzed in NVivo using template analysis whereas quantitative data were analyzed in STATA using Kruskall-Wallis tests. The questionnaire asked respondents about their perceptions of AMS, as well as the perceived barriers and drivers of AMS efforts.
Perceptions of what AMS meant to the respondents personally and their profession as a whole were grouped into 3 main themes: 1) AMS strategies or considerations in antimicrobial prescribing and use; 2) responsibility to maintain health and preserve antimicrobial effectiveness; and 3) reducing antimicrobial use (AMU) as a goal of AMS efforts. Identified AMS barriers had 3 main themes: 1) lack of various prescribing and AMU support mechanisms; 2) shift in prescriber attitudes to drive change; and 3) stronger economic considerations to support shifting prescribing practices. Drivers of AMS had the following themes: 1) leadership to guide change; 2) education to support optimizing AMU; and 3) research to identify best practices and opportunities for action. Across all questions, 2 cross-cutting themes emerged: 1) a One Health understanding of AMS; and 2) blame placed on others for a lack of AMS success.
Overall, sector-specific, but particularly cross-sectoral AMS drivers and barriers were identified, highlighting the importance of a One Health approach in AMR research and mitigation.
摘要：
■由于抗菌素耐药性（AMR）对现有抗菌药物的疗效构成重大威胁，重要的是要了解如何实施有效和实际的缓解努力，包括抗菌药物管理(AMS)，跨越人类，动物,和环境部门。
■将混合方法问卷虚拟分发给虚拟的OneHealth抗菌药物管理会议（2021年3月10日至12日）及其专业网络的与会者。受访者（n=81）主要来自兽医（75％）或人类（19％）卫生部门。使用模板分析在NVivo中分析定性数据,而使用Kruskall-Wallis检验在STATA中分析定量数据。问卷询问受访者对AMS的看法，以及AMS努力的感知障碍和驱动因素。
■对AMS对受访者个人和整个职业的意义的认识分为3个主要主题：1）AMS策略或在抗菌药物处方和使用方面的考虑；2）维护健康和保持抗菌药物有效性的责任；3）减少抗菌药物使用（AMU）作为AMS工作的目标。确定的AMS障碍有3个主要主题：1）缺乏各种处方和AMU支持机制；2）改变处方者的态度以推动变革；3）更强有力的经济考虑以支持不断变化的处方做法。AMS的驱动因素有以下主题：1）领导以指导变革；2）教育以支持优化AMU；3）研究以确定最佳实践和行动机会。在所有问题中，出现了2个交叉主题：1）对AMS的一种健康理解；2）由于缺乏AMS的成功而归咎于他人。
■总的来说，特定部门，但特别是跨部门的AMS驱动因素和障碍被确定，强调“一个健康”方法在AMR研究和缓解中的重要性。
■将混合方法问卷虚拟分发给虚拟的OneHealth抗菌药物管理会议（2021年3月10日至12日）及其专业网络的与会者。受访者（n=81）主要来自兽医（75％）或人类（19％）卫生部门。使用模板分析在NVivo中分析定性数据,而使用Kruskall-Wallis检验在STATA中分析定量数据。问卷询问受访者对AMS的看法，以及AMS努力的感知障碍和驱动因素。
■对AMS对受访者个人和整个职业的意义的认识分为3个主要主题：1）AMS策略或在抗菌药物处方和使用方面的考虑；2）维护健康和保持抗菌药物有效性的责任；3）减少抗菌药物使用（AMU）作为AMS工作的目标。确定的AMS障碍有3个主要主题：1）缺乏各种处方和AMU支持机制；2）改变处方者的态度以推动变革；3）更强有力的经济考虑以支持不断变化的处方做法。AMS的驱动因素有以下主题：1）领导以指导变革；2）教育以支持优化AMU；3）研究以确定最佳实践和行动机会。在所有问题中，出现了2个交叉主题：1）对AMS的一种健康理解；2）由于缺乏AMS的成功而归咎于他人。
■总的来说，特定部门，但特别是跨部门的AMS驱动因素和障碍被确定，强调“一个健康”方法在AMR研究和缓解中的重要性。
