Evidence map›Paper›PMID 39502743›Full record

ArticleJAC-antimicrobial resistance2024

Impact of a hub-and-spoke approach to hospital antimicrobial stewardship programmes on antibiotic use in Zambia.

Aubrey Chichonyi Kalungia, Martin Kampamba, David Banda, Andrew Munkuli Bambala, Sarah Marshall, Melanie Newport, Anja St Clair-Jones, Luke Alutuli, Elias Chambula, Lucky Munsaka and 6 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in JAC-antimicrobial resistance, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
  4. Article
  5. Review
  6. Article
  7. Article
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Aubrey Chichonyi KalungiaDepartment of Pharmacy, University of Zambia, PO Box 50110, Lusaka, Zambia.ORCID https://orcid.org/0000-0003-2554-1236
Martin KampambaDepartment of Pharmacy, University of Zambia, PO Box 50110, Lusaka, Zambia.
David BandaFaculty of Health Sciences, Chreso University, PO Box 37178, Lusaka, Zambia.
Andrew Munkuli BambalaPharmacy Department, University Teaching Hospitals - Adult Hospital, Private Bag RW 1X, Lusaka, Zambia.
Sarah MarshallBrighton and Sussex Medical School, University of Sussex, Falmer, Brighton BN1 9PX, UK.
Melanie NewportBrighton and Sussex Medical School, University of Sussex, Falmer, Brighton BN1 9PX, UK.
Anja St Clair-JonesPharmacy Department, University Hospitals Sussex NHS Foundation Trust, Brighton BN2 5BE, UK.
Luke AlutuliDepartment of Clinical Care & Diagnostic Services, Ministry of Health Headquarters, PO Box 30205, Lusaka, Zambia.
Elias ChambulaPharmacy Department, University Teaching Hospitals - Adult Hospital, Private Bag RW 1X, Lusaka, Zambia.
Lucky MunsakaExecutive Committee, Hospital Pharmacists Association of Zambia, PO Box FW 469, Lusaka, Zambia.
Audrey HamachilaDepartment of Pharmacy, University of Zambia, PO Box 50110, Lusaka, Zambia.
Chiluba MwilaDepartment of Pharmacy, University of Zambia, PO Box 50110, Lusaka, Zambia.
Duncan ChandaDepartment of Internal Medicine, University Teaching Hospitals - Adult Hospital, Private Bag RW 1X, Lusaka, Zambia.ORCID https://orcid.org/0000-0001-5477-9054
Joseph ChizimuAntimicrobial Resistance Coordinating Committee, Zambia National Public Health Institute, Stand 1186, Lusaka, Zambia.
Roma ChilengiAntimicrobial Resistance Coordinating Committee, Zambia National Public Health Institute, Stand 1186, Lusaka, Zambia.
Michael OkorieBrighton and Sussex Medical School, University of Sussex, Falmer, Brighton BN1 9PX, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Antimicrobial stewardship programmes (ASPs) aim to optimize antibiotic use and prevent antimicrobial resistance. Objective: This study assessed the impact of ASPs, initiated using a hub-and-spoke approach, on antibiotic use in Zambian public hospitals. Methods: A pre-post study was conducted in 10 ASP-naive hospitals across Zambia using the Centers for Disease Control and Prevention (CDC)'s hospital-based ASP core elements (i.e. leadership, accountability, pharmacy expertise, stewardship actions, tracking progress, reporting and education) checklist and the global point prevalence survey methodology. The intervention involved technical staff from a national 'hub' hospital with an established ASP providing on-site orientation and mentorship to multidisciplinary teams of healthcare workers at 10 'spoke' hospitals to build capacity in antimicrobial stewardship. ASP core elements and inpatient antibiotic use prevalence (AUP) were assessed before and 12 months after ASP implementation. Data were statistically analysed. Results: The adoption of ASP core elements improved significantly ( Conclusions: The hub-and-spoke approach successfully catalysed ASPs in public hospitals in Zambia, demonstrating the potential for improving antibiotic use practices over time, provided structural challenges are addressed. This approach and insights can guide stakeholders in Zambia and similar settings in enhancing hospital ASPs.

Identifiers

PMID39502743
PMCPMC11535659

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.