{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T18:28:20Z","timestamp":1789410500730,"version":"build-2803163510"},"reference-count":27,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2024,12,26]],"date-time":"2024-12-26T00:00:00Z","timestamp":1735171200000},"content-version":"unspecified","delay-in-days":360,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ASHE"],"published-print":{"date-parts":[[2024]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:sec id=\"S2732494X24004613_as1\">\n\t    <jats:title>Background:<\/jats:title>\n\t    <jats:p>Antimicrobial stewardship programs (ASPs) aim to mitigate antimicrobial resistance (AMR) by optimizing antibiotic use including reducing unnecessary broad-spectrum therapy. This study evaluates the impact of ASP funding and resources on the use of broad-spectrum antibiotics in Ontario hospitals.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X24004613_as2\">\n\t    <jats:title>Methods:<\/jats:title>\n\t    <jats:p>We conducted a cross-sectional study of antimicrobial use (AMU) across 63 Ontario hospitals from April 2020 to March 2023. The Ontario ASP Landscape Survey provided data on ASP resourcing and antibiotic utilization. The main outcome was the proportion of all antibiotics that were broad-spectrum, defined as: fluoroquinolones; third-generation cephalosporins; beta-lactam\/beta-lactamase inhibitors; carbapenems; clindamycin; and parenteral vancomycin. Secondary outcomes included the proportions of individual antibiotic classes listed above and anti-pseudomonal agents. Statistical analysis involved logistic regression to determine the odds ratio (OR) of the association between ASP funding\/resourcing and broad-spectrum antibiotic use.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X24004613_as3\">\n\t    <jats:title>Results:<\/jats:title>\n\t    <jats:p>Among 63 hospitals, 48 reported designated ASP funding\/resources. Median broad-spectrum antibiotic use was 52.5%. ASP funding\/resources was not associated with overall broad-spectrum antibiotic use (0.97, 95% CI: 0.75\u20131.25, <jats:italic>P<\/jats:italic> = 0.79). However, funding was associated with lower use of fluoroquinolones (OR 0.67, 95% CI: 0.46\u20130.96, <jats:italic>P<\/jats:italic> = 0.03), clindamycin (OR 0.69, 95% CI: 0.47\u20131.00, <jats:italic>P<\/jats:italic> = 0.05), and anti-pseudomonal agents (OR 0.76, 95% CI: 0.59\u20130.98, <jats:italic>P<\/jats:italic> = 0.03).<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X24004613_as4\">\n\t    <jats:title>Conclusion:<\/jats:title>\n\t    <jats:p>The presence of designated funding and resources for hospital ASPs is linked to reduced use of specific broad-spectrum antibiotics but not overall broad-spectrum antibiotic use. Enhancing ASP resourcing may be an important factor in limiting targeted antibiotic use, thereby increasing the effectiveness of efforts to mitigate AMR.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1017\/ash.2024.461","type":"journal-article","created":{"date-parts":[[2024,12,26]],"date-time":"2024-12-26T03:30:33Z","timestamp":1735183833000},"source":"Crossref","is-referenced-by-count":5,"title":["Hospital antimicrobial stewardship funding and resourcing impact on broad-spectrum antibiotic use: a cross-sectional study"],"prefix":"10.1017","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7405-0500","authenticated-orcid":false,"given":"Megan","family":"Tu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zong Heng","family":"Shi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerie","family":"Leung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1483-2188","authenticated-orcid":false,"given":"Kevin A","family":"Brown","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3666-7005","authenticated-orcid":false,"given":"Kevin L","family":"Schwartz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nick","family":"Daneman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5467-6776","authenticated-orcid":false,"given":"Bradley J","family":"Langford","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2024,12,26]]},"reference":[{"key":"S2732494X24004613_ref9","doi-asserted-by":"publisher","DOI":"10.1093\/jacamr\/dlac134"},{"key":"S2732494X24004613_ref20","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofad413"},{"key":"S2732494X24004613_ref23","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(23)00686-2"},{"key":"S2732494X24004613_ref24","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/civ1199"},{"key":"S2732494X24004613_ref25","doi-asserted-by":"publisher","DOI":"10.1086\/677633"},{"key":"S2732494X24004613_ref13","unstructured":"13. Ontario Ministry of Health. Ministry reports: Master Numbering System [Internet]. 2024. Available from: https:\/\/www.ontario.ca\/page\/ministry-reports-master-numbering-system. Accessed January 10, 2024."},{"key":"S2732494X24004613_ref8","doi-asserted-by":"publisher","DOI":"10.9778\/cmajo.20170111"},{"key":"S2732494X24004613_ref26","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2017.94"},{"key":"S2732494X24004613_ref27","doi-asserted-by":"publisher","DOI":"10.1017\/ash.2022.268"},{"key":"S2732494X24004613_ref12","unstructured":"12. World Health Organization. 2021 AWaRe classification: WHO access, watch, reserve, classification of antibiotics for evaluation and monitoring of use [Internet]. 2021. Available from: https:\/\/www.who.int\/publications\/i\/item\/2021-aware-classification. Accessed March 25, 2024."},{"key":"S2732494X24004613_ref17","doi-asserted-by":"publisher","DOI":"10.1007\/s11908-018-0615-z"},{"key":"S2732494X24004613_ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2018.03.021"},{"key":"S2732494X24004613_ref11","unstructured":"11. World Health Organization Collaborating Centre for Drug Statistics Methodology. ATC\/DDD Index 2020 [Internet]. Available from: https:\/\/www.whocc.no\/atc_ddd_index\/. 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Accessed January 23, 2024."}],"container-title":["Antimicrobial Stewardship &amp; Healthcare Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S2732494X24004613","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,26]],"date-time":"2024-12-26T03:30:40Z","timestamp":1735183840000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S2732494X24004613\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024]]},"references-count":27,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025]]}},"alternative-id":["S2732494X24004613"],"URL":"https:\/\/doi.org\/10.1017\/ash.2024.461","relation":{},"ISSN":["2732-494X"],"issn-type":[{"value":"2732-494X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024]]},"article-number":"e223"}}