start-ver=1.4 cd-journal=joma no-vol=31 cd-vols= no-issue=7 article-no= start-page=102730 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2025 dt-pub=202507 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Impact of full-time equivalent allocation on the effectiveness of antimicrobial stewardship activities: A multicenter study in Okayama, Japan en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background: Optimized administration of antimicrobial agents is critical for mitigating the emergence of antimicrobial resistance. This study aimed to elucidate the relationship between antimicrobial stewardship (AS) activities and antimicrobial prescription trends and patterns.
Methods: This retrospective, multicenter, longitudinal study was conducted between April 2014 and March 2023 (9-year fiscal period). A structured, questionnaire survey, regarding institutional infrastructure and environmental parameters, service modalities provided by AS activities, resource allocation and systemic support, and data on the use of broad-spectrum antimicrobial agents, was distributed to co-investigators working at seven hospitals in Okayama, Japan. Full-time equivalent (FTE) allocation for each healthcare facility were calculated and subsequently compared among the hospitals. Temporal variations in the proportional distribution of broad-spectrum antimicrobial agents were statistically evaluated using joinpoint regression analysis.
Results: Two hospitals where pharmacists were exclusively dedicated to AS activities and met the recommended FTE allocation showed a statistically significant reduction in the proportion of broad-spectrum antibiotic administration, with average annual percentage changes of ?8.0 % (95 % confidence interval [CI]: ?10.5 to ?5.8) and ?3.1 % (95 % CI: ?5.5 to ?0.7), respectively. In contrast, two other hospitals with full-time AS members but insufficient FTE allocation exhibited inconsistent and statistically nonuniform trends. The remaining three healthcare institutions with poorly resourced AS teams demonstrated no statistically significant trends in their broad-spectrum antimicrobial prescriptions.
Conclusion: Our findings uncovered that hospitals with adequate FTE staffing metrics for AS activities exhibited statistically significant downward trends in the consumption of broad-spectrum antimicrobial agents. en-copyright= kn-copyright= en-aut-name=KajitaShiho en-aut-sei=Kajita en-aut-mei=Shiho kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=HagiyaHideharu en-aut-sei=Hagiya en-aut-mei=Hideharu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=OkitaAtsushi en-aut-sei=Okita en-aut-mei=Atsushi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=HarukiYuto en-aut-sei=Haruki en-aut-mei=Yuto kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=YamadaHaruto en-aut-sei=Yamada en-aut-mei=Haruto kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=InoueYasurou en-aut-sei=Inoue en-aut-mei=Yasurou kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=HigashionnaTsukasa en-aut-sei=Higashionna en-aut-mei=Tsukasa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=SatouKana en-aut-sei=Satou en-aut-mei=Kana kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=TorigoeFumihiro en-aut-sei=Torigoe en-aut-mei=Fumihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=IwamotoShinobu en-aut-sei=Iwamoto en-aut-mei=Shinobu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=YoshidaMika en-aut-sei=Yoshida en-aut-mei=Mika kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=YamaneYumiko en-aut-sei=Yamane en-aut-mei=Yumiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=KenmotsuHiroki en-aut-sei=Kenmotsu en-aut-mei=Hiroki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=SugimuraSatoru en-aut-sei=Sugimura en-aut-mei=Satoru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= en-aut-name=FujiwaraYutaka en-aut-sei=Fujiwara en-aut-mei=Yutaka kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=15 ORCID= en-aut-name=IkedaFusao en-aut-sei=Ikeda en-aut-mei=Fusao kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=16 ORCID= en-aut-name=KoyamaToshihiro en-aut-sei=Koyama en-aut-mei=Toshihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=17 ORCID= en-aut-name=YoshidaChikamasa en-aut-sei=Yoshida en-aut-mei=Chikamasa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=18 ORCID= en-aut-name=AndouShinichirou en-aut-sei=Andou en-aut-mei=Shinichirou kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=19 ORCID= en-aut-name=SuwakiToshimitsu en-aut-sei=Suwaki en-aut-mei=Toshimitsu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=20 ORCID= affil-num=1 en-affil=Antimicrobial Stewardship Team, Okayama City Hospital kn-affil= affil-num=2 en-affil=Department of Infectious Diseases, Okayama University Hospital kn-affil= affil-num=3 en-affil=Department of Surgery, Setouchi City Hospital kn-affil= affil-num=4 en-affil=Department of Pharmacy, Tsuyama Chuo Hospital kn-affil= affil-num=5 en-affil=Antimicrobial Stewardship Team, Okayama City Hospital kn-affil= affil-num=6 en-affil=Antimicrobial Stewardship Team, Okayama City Hospital kn-affil= affil-num=7 en-affil=Department of Pharmacy, Okayama University Hospital kn-affil= affil-num=8 en-affil=Division of Pharmacy, Kurashiki Central Hospital kn-affil= affil-num=9 en-affil=Division of Pharmacy, Kurashiki Central Hospital kn-affil= affil-num=10 en-affil=Division of Pharmacy, Okayama Kyoritsu Hospital kn-affil= affil-num=11 en-affil=Infection Control Team, National Hospital Organization Minami-Okayama Medical Center kn-affil= affil-num=12 en-affil=Infection Control Team, National Hospital Organization Minami-Okayama Medical Center kn-affil= affil-num=13 en-affil=Division of Pharmacy, Okayama Saiseikai Hospital kn-affil= affil-num=14 en-affil=Department of Internal Medicine, Okayama Kyoritsu Hospital kn-affil= affil-num=15 en-affil=Infection Control Team, National Hospital Organization Minami-Okayama Medical Center kn-affil= affil-num=16 en-affil=Department of Hepatology, Okayama Saiseikai Hospital kn-affil= affil-num=17 en-affil=Department of Health Data Science, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=18 en-affil=Infection Control Team, Okayama City Hospital kn-affil= affil-num=19 en-affil=Infection Control Team, Okayama City Hospital kn-affil= affil-num=20 en-affil=Infection Control Team, Okayama City Hospital kn-affil= en-keyword=Antimicrobial resistance kn-keyword=Antimicrobial resistance en-keyword=Antimicrobial stewardship kn-keyword=Antimicrobial stewardship en-keyword=Full-time equivalent kn-keyword=Full-time equivalent en-keyword=Infection prevention and control kn-keyword=Infection prevention and control en-keyword=Trend analysis kn-keyword=Trend analysis END