Imperial College London
Alternate

DrGabrielBirgand

Faculty of Medicine, Department of Infectious Disease

Honorary Research Fellow
 
 
 
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Contact

 

+44 (0)20 3313 2732g.birgand Website CV

 
 
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Location

 

Commonwealth BuildingHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Perozziello:2018:10.1016/j.ijantimicag.2018.01.002,
author = {Perozziello, A and Routelous, C and Charani, E and Truel, A and Birgand, GJC and Yazdanpanah, Y and Lescure, FX and Lucet, J-C},
doi = {10.1016/j.ijantimicag.2018.01.002},
journal = {International Journal of Antimicrobial Agents},
pages = {829--835},
title = {Experiences and perspectives of implementing antimicrobial stewardship in five French hospitals: a qualitative study},
url = {http://dx.doi.org/10.1016/j.ijantimicag.2018.01.002},
volume = {51},
year = {2018}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - ObjectiveTo describe current antimicrobial stewardship program (ASP) in France, both at policy level and at local implementation level, and to assess how ASP leaders (ASPL) worked and prioritised their activities.MethodsWe conducted a qualitative study based on face-to-face semi-structured interviews with healthcare professionals responsible for ASP across five French hospitals. Five infectious disease specialists and one microbiologist were interviewed between April and June 2016.ResultsStewards had dedicated time to perform ASP activities in two university-affiliated hospitals while in the other hospitals (one university, one general and one semi-private), ASPLs had to balance these activities with clinical practice. Consequently, they had to adapt interventions according to their resources (IT or human). Responding to colleagues' consultation requests formed baseline work. Systematic and pro-active measures allowed for provision of unsolicited counselling, while direct counselling on wards required appropriate staffing. ASPL aimed at increasing clinicians' ability to prescribe adequately and awareness of the unintended consequences of inappropriate use of antibiotics. Thus, persuasive e.g. education measures were preferred to coercive ones. ASPL faced several challenges in implementing ASP: overcoming physicians' or units' reluctance, and balancing the influence of medical hierarchy and professional boundaries.ConclusionBeyond resources constraints, ASPLs' conceptions of their work, as well as contextual and cultural aspects, led them to adopt a persuasive and collaborative approach of counselling. This is the first qualitative study about ASP in France exploring stewards' experiences and points of view.
AU  - Perozziello,A
AU  - Routelous,C
AU  - Charani,E
AU  - Truel,A
AU  - Birgand,GJC
AU  - Yazdanpanah,Y
AU  - Lescure,FX
AU  - Lucet,J-C
DO  - 10.1016/j.ijantimicag.2018.01.002
EP  - 835
PY  - 2018///
SN  - 0924-8579
SP  - 829
TI  - Experiences and perspectives of implementing antimicrobial stewardship in five French hospitals: a qualitative study
T2  - International Journal of Antimicrobial Agents
UR  - http://dx.doi.org/10.1016/j.ijantimicag.2018.01.002
UR  - http://hdl.handle.net/10044/1/57069
VL  - 51
ER  -
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