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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Exploring the views of infection consultants in England on a novel delinked funding model for antimicrobials: the SMASH study
JAC-Antimicrobial Resistance, Volume 5, No. 4, Article dlad091, Year 2023
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Description
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. © 2023 The Author(s). Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy.
Authors & Co-Authors
Gilchrist, Mark J.
United Kingdom, London
Imperial College London
Gibani, Malick M.M.
United Kingdom, London
Imperial College London
Meiring, James E.
United Kingdom, Sheffield
The University of Sheffield
Otu, Akaninyene Asuquo
United Kingdom, Leeds
Leeds Teaching Hospitals Nhs Trust
Thompson, Ameeka L.
United Kingdom, Bristol
North Bristol Nhs Trust
Price, James Richard
United Kingdom, Brighton
Brighton and Sussex Medical School
United Kingdom, Worthing
University Hospitals Sussex Nhs Foundation Trust
Crocker-Buqué, Tim
United Kingdom, London
Royal Free London Nhs Foundation Trust
Smith, Chris
United Kingdom, London
Imperial College London
Lamb, Thomas
United Kingdom, Oxford
University of Oxford
Thailand
Mahosot Hospital, Lao
Waddington, Claire S.
United Kingdom, London
Imperial College London
Moore, Luke SP
United Kingdom, London
Imperial College London
United Kingdom, London
Chelsea and Westminster Hospital
Aiken, Alexander M.
United Kingdom, London
London School of Hygiene & Tropical Medicine
Statistics
Authors: 12
Affiliations: 26
Identifiers
Doi:
10.1093/jacamr/dlad091
ISSN:
26321823
Research Areas
Cancer
Study Design
Cross Sectional Study
Study Approach
Quantitative