# P-984. A Novel Tool for Assessing Antibiotic Stewardship Programs in Inpatient Healthcare Facilities Across the Globe

## TL;DR

A new tool called G-ASET was developed to evaluate antibiotic stewardship programs in hospitals worldwide, highlighting areas for improvement.

## Contribution

The novel Global Antibiotic Stewardship Evaluation Tool (G-ASET) was developed and validated for assessing antibiotic stewardship in diverse healthcare settings.

## Key findings

- G-ASET scores ranged from 40.4% to 89.7% across 75 healthcare facilities.
- Education and training had the lowest domain score (53.7%), while AS actions had the highest (74.3%).
- Significant variability in antibiotic stewardship practices was observed among participating facilities.

## Abstract

Antibiotic stewardship (AS) practices vary widely across countries based on available infrastructure and resources. Thus, implementing AS in healthcare facilities (HCFs) across the globe cannot take a "one-size-fits-all" approach. In collaboration with Johns Hopkins University, University of Oxford with Duke University, and the University of Pennsylvania, the US CDC developed and validated a Global Antibiotic Stewardship Evaluation Tool (G-ASET) to help inpatient HCFs assess their AS practices and needs. Of note, the G-ASET is not intended to compare data across countries. An evaluation was performed using G-ASET to describe improvement opportunities in HCFs in Latin America, Asia, and Southern Africa.Figure 1.Distribution of the 75 Participating Inpatient Healthcare FacilitiesFigure 2.G-ASET Domain Scores (N=75 Participating Inpatient Healthcare Facilities)

Distribution of the 75 Participating Inpatient Healthcare Facilities

G-ASET Domain Scores (N=75 Participating Inpatient Healthcare Facilities)

Between July 2021-December 2022, G-ASET was developed using a multi-step process that emphasized clinical relevancy and feasibility including literature evaluation, multiple rounds of revision by a multidisciplinary team of AS experts, and assembly of an expert consensus panel using a modified Delphi approach. Assessment items in G-ASET are organized using 5 domains: 1) leadership commitment & accountability, 2) resources, 3) education & training, 4) AS actions, 5) antibiotic use tracking, monitoring, & reporting. The tool was validated by pilot testing in 10 sites: Argentina (n=3), Vietnam (n=1), Botswana (n=2), US (n=4). Finally, we performed a cross-sectional evaluation of AS programs using G-ASET in inpatient HCFs across 12 low- and middle-income countries between January 2023-April 2024 (Figure 1). Convenience sampling was used to purposively select diverse facilities. Overall and domain scores were calculated by summing points earned and converting to a percentage of potential points. Descriptive statistics were used for analysis.

Seventy-five inpatient HCFs were included in this evaluation (Figure 1). Overall G-ASET scores ranged from 40.4-89.7% across the HCFs. Education and training was the lowest scoring domain (53.7%) whereas AS actions was the highest scoring domain (74.3%) (Figure 2).

Significant variability in overall G-ASET scores was observed among participating inpatient HCFs. The newly launched G-ASET can help to identify specific opportunities for improvement among AS programs in inpatient HCFs across the globe.

Payal K. Patel, MD, MPH, FIDSA, Cormedix: Advisor/Consultant Elizabeth Dodds Ashley, PharmD, MHS, HealthtrackRx: Advisor/Consultant|UpToDate, Inc.: Author Royalties Keith W. Hamilton, MD, BioMerieux: Grant/Research Support