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Table 4 Barriers to implementation of AMS

From: Assessing the impact of the Global Point Prevalence Survey of Antimicrobial Consumption and Resistance (Global-PPS) on hospital antimicrobial stewardship programmes: results of a worldwide survey

  n (%)
High-income countries (n = 80) Low- and middle-income countries (n = 163) Total (n = 243) p-value* (α = 0.0026)
Lack of time to perform AMS activities 50 (62.5) 78 (47.9) 128 (52.7) 0.044
Lack of knowledge on good prescribing practices 28 (35.0) 74 (45.4) 102 (42.0) 0.160
Lack of funding for AMS programme 41 (51.3) 56 (34.4) 97 (39.9) 0.017
Lack of cooperation from prescribers 21 (26.3) 67 (41.1) 88 (36.2) 0.034
Lack of information technology 37 (46.3) 36 (22.1) 73 (30.0)  < 0.001
Unavailability of prescribing guidelines 6 (7.5) 58 (35.6) 64 (26.3)  < 0.001
Lack of qualified personnel 13 (16.3) 44 (27.0) 57 (23.5) 0.090
Lack of support from hospital management 14 (17.5) 40 (24.5) 54 (22.2) 0.282
Insufficient laboratory capacity 10 (12.5) 57 (35.0) 54 (22.2)  < 0.001
Lack of expertise/training within the AMS team 13 (16.3) 32 (19.6) 45 (18.5) 0.644
Suboptimal use of laboratory services 2 (2.5) 35 (21.5) 37 (15.2)  < 0.001
Lack of confidence in the hospital's IPC** processes 4 (5.0) 29 (17.8) 33 (13.6) 0.011
Lack of trust in prescribing guidelines 7 (8.8) 23 (14.1) 30 (12.4) 0.324
Regular shortages/stock outs of essential antibiotics 4 (5.0) 24 (14.7) 28 (11.5) 0.044
Patient demands 7 (8.8) 18 (11.0) 25 (10.3) 0.743
Poor quality of antibiotics 0 (0.0) 15 (9.2) 15 (6.2) 0.003
High cost of antibiotics 0 (0.0) 15 (9.2) 15 (6.2) 0.003
No barriers 5 (6.3) 1 (0.6) 6 (2.5) 0.016
  1. *Statistical significance evaluated using the Pearson’s chi-squared test or Fisher’s exact test. Significance level (α) has been corrected for multiple testing. **Infection prevention and control
  2. Values in boldface indicate statistical significance