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Exploring the views of infection consultants in England on a novel delinked funding model for antimicrobials: the SMASH study.
Baltas, Ioannis; Gilchrist, Mark; Koutoumanou, Eirini; Gibani, Malick M; Meiring, James E; Otu, Akaninyene; Hettle, David; Thompson, Ameeka; Price, James R; Crepet, Anna; Atomode, Abolaji; Crocker-Buque, Timothy; Spinos, Dimitrios; Guyver, Hudson; Tausan, Matija; Somasunderam, Donald; Thoburn, Maxwell; Chan, Cathleen; Umpleby, Helen; Sharp, Bethany; Chivers, Callum; Vaghela, Devan Suresh; Shah, Ronak J; Foster, Jonathan; Hume, Amy; Smith, Christopher; Asif, Ammara; Mermerelis, Dimitrios; Reza, Mohammad Abbas; Haigh, Dominic A; Lamb, Thomas; Karatzia, Loucia; Bramley, Alexandra; Kadam, Nikhil; Kavallieros, Konstantinos; Garcia-Arias, Veronica; Democratis, Jane; Waddington, Claire S; Moore, Luke S P; Aiken, Alexander M.
Afiliación
  • Baltas I; Imperial College Healthcare NHS Trust, London, UK.
  • Gilchrist M; Institute of Education, University College London, London, UK.
  • Koutoumanou E; Imperial College Healthcare NHS Trust, London, UK.
  • Gibani MM; Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, UK.
  • Meiring JE; Population, Policy & Practice Research and Teaching Department, Great Ormond Street Institute of Child Health, University College London, London, UK.
  • Otu A; Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, UK.
  • Hettle D; Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK.
  • Thompson A; Department of Microbiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
  • Price JR; Department of Infection Sciences, Southmead Hospital, North Bristol NHS Trust, Bristol, UK.
  • Crepet A; Department of Infection Sciences, Southmead Hospital, North Bristol NHS Trust, Bristol, UK.
  • Atomode A; Brighton and Sussex Medical School, University of Sussex, Brighton, UK.
  • Crocker-Buque T; University Hospitals Sussex NHS Foundation Trust, Brighton, UK.
  • Spinos D; University Hospitals Sussex NHS Foundation Trust, Brighton, UK.
  • Guyver H; Liverpool University NHS Foundation Trust, Liverpool, UK.
  • Tausan M; Department of Microbiology, Royal Free London NHS Foundation Trust, London, UK.
  • Somasunderam D; Department of ENT, Head and Neck Surgery, Gloucester Royal Hospital, Gloucestershire Hospitals NHS Foundation Trust, Gloucester, UK.
  • Thoburn M; James Paget University Hospitals NHS Foundation Trust, Norfolk, UK.
  • Chan C; Chelsea and Westminster Hospital NHS Foundation Trust, London, UK.
  • Umpleby H; Bart's Health NHS Trust, London, UK.
  • Sharp B; University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
  • Chivers C; University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
  • Vaghela DS; Hampshire Hospitals NHS Foundation Trust, Hampshire, UK.
  • Shah RJ; Nottingham University Hospitals NHS Trust, Nottingham, UK.
  • Foster J; Nottingham University Hospitals NHS Trust, Nottingham, UK.
  • Hume A; Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK.
  • Smith C; Imperial College Healthcare NHS Trust, London, UK.
  • Asif A; Directorate of Pharmacy, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK.
  • Mermerelis D; Directorate of Pharmacy, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK.
  • Reza MA; Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, UK.
  • Haigh DA; Hull University Teaching Hospitals NHS Trust, Hull, UK.
  • Lamb T; Maidstone and Tunbridge Wells NHS Trust, Kent, UK.
  • Karatzia L; Northwest Anglia NHS Foundation Trust, Peterborough, UK.
  • Bramley A; Manchester University NHS Foundation Trust, Manchester, UK.
  • Kadam N; Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK.
  • Kavallieros K; Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Vientiane, Lao People's Democratic Republic.
  • Garcia-Arias V; Oxford University Hospitals NHS Trust, Oxford, UK.
  • Democratis J; St George's University Hospitals NHS Foundation Trust, London, UK.
  • Waddington CS; Mid and South Essex NHS Trust, Westcliff-on-Sea, UK.
  • Moore LSP; Faculty of Medicine, Imperial College London, London, UK.
  • Aiken AM; Hampshire Hospitals NHS Foundation Trust, Hampshire, UK.
JAC Antimicrob Resist ; 5(4): dlad091, 2023 Aug.
Article en En | MEDLINE | ID: mdl-37533762
Objectives: A novel 'subscription-type' funding model was launched in England in July 2022 for ceftazidime/avibactam and cefiderocol. We explored the views of infection consultants on important aspects of the delinked antimicrobial funding model. Methods: An online survey was sent to all infection consultants in NHS acute hospitals in England. Results: The response rate was 31.2% (235/753). Most consultants agreed the model is a welcome development (69.8%, 164/235), will improve treatment of drug-resistant infections (68.5%, 161/235) and will stimulate research and development of new antimicrobials (57.9%, 136/235). Consultants disagreed that the model would lead to reduced carbapenem use and reported increased use of cefiderocol post-implementation. The presence of an antimicrobial pharmacy team, requirement for preauthorization by infection specialists, antimicrobial stewardship ward rounds and education of infection specialists were considered the most effective antimicrobial stewardship interventions. Under the new model, 42.1% (99/235) of consultants would use these antimicrobials empirically, if risk factors for antimicrobial resistance were present (previous infection, colonization, treatment failure with carbapenems, ward outbreak, recent admission to a high-prevalence setting).Significantly higher insurance and diversity values were given to model antimicrobials compared with established treatments for carbapenem-resistant infections, while meropenem recorded the highest enablement value. Use of both 'subscription-type' model drugs for a wide range of infection sites was reported. Respondents prioritized ceftazidime/avibactam for infections by bacteria producing OXA-48 and KPC and cefiderocol for those producing MBLs and infections with Stenotrophomonas maltophilia, Acinetobacter spp. and Burkholderia cepacia. Conclusions: The 'subscription-type' model was viewed favourably by infection consultants in England.

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Prognostic_studies / Risk_factors_studies Idioma: En Revista: JAC Antimicrob Resist Año: 2023 Tipo del documento: Article Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Prognostic_studies / Risk_factors_studies Idioma: En Revista: JAC Antimicrob Resist Año: 2023 Tipo del documento: Article Pais de publicación: Reino Unido