As the list of antibiotic-resistant pathogens continues to grow, antimicrobial stewardship has become a key issue for both hospital and outpatient clinics, including those hospitals in the federal healthcare space.
At the AMSUS 2025 meeting, LeeAnne Lynch, PhD, MPH, who formerly worked with the Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences in Bethesda, MD, and colleagues reported on the results of an analysis of Department of Defense antimicrobial stewardship programs (ASPs) to assess where improvements could be made.
In a poster, Lynch and colleagues noted they used observational retrospective analysis, with longitudinal data from the National Healthcare Safety Network that included approximately 48 hospitals and researcher surveys for both inpatient and outpatient clinics to take a more comprehensive, systemwide look at ASPs, since most available data has been at the facility level, rather than the entire system.
Discussing overall patterns of the program, the researchers noted that ASP leaders were more likely to have been assigned to a stewardship program than volunteered for them and that the programs usually occupied 1% to 25% of their time. They noted that stewardship programs were present in far more ambulatory clinics compared with dental clinics, at 96.3% compared with 51.7% at dental clinics. In hospitals, 67.5% of ASPs consisted of 1% to 25% pharmacists, compared with 35.3% of outpatient ASPs that were comprised of 1% to 25% pharmacists.
Pharmacists spent more time on the stewardship program than physicians, with approximately 42% noting they spent more than a quarter of their time on stewardship than their physician colleagues, of whom 75% reported spending less than a quarter of their time on stewardship.
Although the hospitals and outpatient clinics largely adhered to the Centers for Disease Control and Prevention’s core elements recommendations, the researchers noted that qualitative scoring methods would have shed better insights into the quality improvement initiatives. Some of these core elements include hospital leadership commitment, accountability, pharmacy expertise, action, tracking, reporting, and education on stewardship efforts in the hospital setting, and commitment, action for policy and practice, tracking and reporting, and education and expertise in the outpatient setting.
The researcher concluded: “an expanded AS leader network expanding outpatient contacts would aid communication/dissemination of evidence-based practices.”
The researchers also urged continued refinement and standardization of stewardship evaluations in inpatient and outpatient settings so that areas for improvement could be more quickly identified and addressed in these environments.
Reference
Lynch LC, Mende K, Hamdy RF, et al. Evaluation of Department of Defense antimicrobial stewardship programs: structure and outcomes. Presented at AMSUS 2025. March 3-5, 2025. Poster 115.