ASAP: promoting good antibiotic prescription practice in ambulatory care
10.07.2024 - Switzerland’s Antimicrobial Stewardship in Ambulatory Care Platform (ASAP) is intended to promote good practices in the prescription of antibiotics in the country’s ambulatory care sector and, in the longer term, to help reduce antibiotic resistance nationwide. The platform has been established under the broader Swiss Strategy on Antibiotic Resistance (StAR) and developed in collaboration with the College of Primary Care Medicine (CPCM).
The rise of antimicrobial resistance is closely linked to the practices of prescribing antibiotics, some 85% of which is done in the outpatient or ambulatory care sector. Antimicrobial stewardship or AMS is an organised approach that is designed to promote the measured and appropriate prescription of antibiotic medicines. AMS programmes are already well established in hospitals, but are rare in the ambulatory care sector, even though the majority of the antibiotics consumed by the Swiss population are prescribed by primary care physicians to treat acute infections.
Various AMS-related ambulatory care initiatives have been developed in Switzerland over the past few years, particularly within the framework of the Swiss Strategy on Antibiotic Resistance (StAR) that was launched in 2016 and the NRP 72 national antimicrobial resistance research programme. These efforts have spawned a strong collaborative dynamic among the various parties involved. But they still need to be further pursued in the ambulatory care sector, not least in connection with the StAR 2024-2027 One Health Action Plan.
It is in this context that the ASAP project, which is financially supported by the FOPH within the broader StAR framework, has been devised, to provide an overall platform for such developments.
The purpose of ASAP is:
- to promote dialogue and collaborations among the researchers, professional associations, patients and authorities involved in the stewardship of the use of antibiotics in the Swiss ambulatory care sector;
- to study and evaluate the data available on the use of antibiotics in ambulatory care, with a view to identifying priority action areas;
- to provide recommendations to the various parties involved on AMS interventions in the ambulatory care sector;
- to support the implementation of AMS interventions based on scientific data in the Swiss ambulatory care sector.
The project is up and running
The first ASAP meeting was held in mid-April 2024. The gathering enabled its various participants (GPs, paediatricians, infectiologists, researchers and representatives from the Swiss Centre for Antibiotic Resistance and the FOPH) to meet and discuss the various tools available for managing the use of antibiotics which could be adapted for use in the ambulatory care sector and their further development potential.
An initial focus was placed in these discussions on the use of antibiotics to treat acute respiratory tract infections. These account for almost half of all prescriptions of antibiotics in Switzerland, and were therefore selected to be the first priority for ASAP’s launch. A second priority focus will be determined by the new platform’s scientific and consultative committee in 2025.
Four prime tools were discussed at this first ASAP meeting:
- An information sheet and decision aid developed by a research team from the University of Bern for the use of primary care physicians. These documents would provide the basic information and illustrate the risk/benefit ratio involved in an antibiotic treatment for various acute infections.
- Paper and audiovisual documents designed to inform patients on the use of antibiotics, developed by the FOPH in collaboration with various medical and pharmaceutical associations. These would consist of a brief video clip and an information sheet highlighting the importance of paying due and full regard to the lengths and the dosages of antibiotic treatments.
- Guidelines from the Swiss Society for Infectious Diseases (SSI), available online. These guidelines would provide information on the appropriate use of antibiotics for 23 infectious diseases, and would be frequently updated.
- Audit and feedback, an intervention consisting in analysing the data on antibiotics prescriptions issued by clinicians and providing them with feedback on their prescription practices compared with those of their peers.
The benefits of ASAP are numerous. In particular, the platform enables the creation and maintenance of a common professional culture of responsible stewardship of antibiotics use, and promotes the involvement of physicians’ offices in establishing information and recommendations on good practices in the field.
An ASAP webpage presenting the project’s objectives, updates and progress to date will be available soon on the CPCM website.
Dove trovarci:
19-20 September 2024, Lugano, at the 8th SSGIM autumn congress, A platform for antimicrobial stewardship in ambulatory care: the ASAP project, Friday 20 September 2024 from 15:30 to 16:15.
Stay tuned !