Antimicrobial Stewardship Research

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Research drives innovation. The Antimicrobial Stewardship Program is committed to discovering new and better ways to promote the best patient outcomes with respect to antimicrobial use and to disseminate our findings to health care practitioners, health care researchers and the general public.

Research Projects

Knowledge and Attitudes of Community Healthcare Workers Towards Antimicrobial Stewardship (2016)

One of the difficult tasks in antimicrobial stewardship is to determine which interventions are best suited to make a positive impact in a particular health care setting (i.e., hospital, community clinic, pharmacy, etc.).  To aid in this process, we performed a survey of community healthcare workers throughout Saskatchewan to better understand what their knowledge and attitudes were towards antimicrobial stewardship.  The knowledge gained in this survey has helped direct us towards stewardship strategies that will be most effective in our community healthcare settings.

Effect of an Educational Intervention on Reducing the Use of Urine Cultures and Antibiotic Treatment of Asymptomatic Bacteriuria in Long Term Care (2017)

Treatment of asymptomatic bacteriuria [bacteria in the urine without symptoms of a urinary tract infection (UTI)] is not recommended, as it is not correlated with decreased morbidity, mortality or the occurence of a UTI, and may cause harm due to development of antimicrobial resistance and potential side effects of antibiotics. The Antimicrobial Stewardship Program is conducting prospective chart audits on residents of long term care facilities to determine the appropriateness of requests for urine culture and sensitivity tests, presence of documented symptoms and their relevance to UTI, and the appropriate use of antibiotics. An educational session will be offered to clinical staff, followed by post-intervention data collection and analysis to determine if education helps reduce inappropriate use of urine cultures and antibiotics.

Find paper here

ICU are on Antibiotics: Antimicrobial Stewardship in Intensive Care (2017)

Care of the critically ill can sometimes come at odds with some aspects of antimicrobial stewardship.  Research has shown an increase in mortality of 10% for every hour of delay in targeted antimicrobial therapy in the critically ill, septic patient.  With a paucity of information or a known source of infection, broad spectrum therapy may be initiated until more information about the patient becomes available.  

Formal antimicrobial stewardship has not been conducted within the Critical Care program of the Regina Qu’Appelle Health Region.  With different resistance patterns in each region, an individualized approach to care needs to be developed.  As trends in current practice remain unknown, this retrospective chart audit assessing antimicrobial stewardship for the treatment of pneumonia in the ICU will create a baseline for critical care, identify what the team is doing well and potential areas for improvement. 

Find paper here

Evaluation of Antimicrobial Stewardship Community Interventions in the Regina Qu'Appelle Health Region (2017)

Despite the fact that antimicrobial stewardship is a global issue with programs being run in acute care settings throughout the world, there is still a relative lack of information regarding implementation of antimicrobial stewardship programs in the community setting.  As such, the first research initiative for our Program was to determine what community-based prescribers understood about antimicrobial stewardship and to gather their ideas about the most effective approach to tackling the issue.  One of the main themes uncovered in this research was that educational tools were necessary to inform patients of the issue and to help guide patients and physicians through choosing appropriate therapy.  With that in mind, our Program developed a website, viral prescription pad, posters, pamphlets, and a series of educational seminars to promote awareness of antimicrobial resistance and to provide prescribers with tools to aid in appropriate prescribing of antibiotics.

Unfortunately, efforts in coordinating antimicrobial stewardship across Canada are still somewhat disjointed.  With mounting pressure from governments and international organizations to promote antimicrobial stewardship across all sectors of human health, it is important that fledgling programs have access to current evidence about best practice in developing a program with community-based practice as part of the focus.  Since a considerable amount of time and effort can be dedicated to developing and distributing educational tools, it is important to understand the uptake and efficacy of those tools in contributing to increased awareness and reduced unnecessary antimicrobial use.  This information will help to aid other programs in determining their use of educational tools as part of a community-based intervention.

To our knowledge, there is no previous research regarding utility of the types of tools we have developed.  The purpose of this study will be to ascertain this information through in-depth interviews with end-users.

Patient Preference for Information Delivery for Management of Upper Respiratory Tract Infection Symptoms in Primary Health Care

There are numerous studies examining the best medium (e.g., verbal communication, printed literature, videos,etc.) through which to provide health care information for patients in various acute care settings (e.g., oncology, surgery, chronic disease).  The answer to the question of whether it is better to provide patients with literature to inform and educate (e.g., about management of a chronic condition or preparation for a procedure) or if verbal instructions from care providers are sufficient, appears to be somewhat dependent on the specifics of the health problem and the health literacy of the patient population.  Some studies find verbal information superior for their outcomes, others find written information to be best, while others find a combination of both to be the ideal.

Unfortunately, among all of this research there is still a paucity of evidence for patients in the primary health care setting, particularly for those suffering from acute upper respiratory tract infections (i.e., bronchitis, acute otitis media, pharyngitis/tonsillitis, rhinitis, sinusitis).  This is an important group of infections because, while the majority (90%) are viral in etiology, they represent the most common conditions with excessive use of antibiotics.  It is important for care providers to reassure patients that their viral illness will not benefit from the use of antibiotics and provide them with advice on symptom relief.  Verbal communication between the care provider and patient is one way of providing this information.  In a previous study, nearly half of family physicians that were interviewed indicated they preferred to provide verbal information alone (regarding symptom management) to patients suffering from viral upper respiratory tract infections.  This research aims to answer the question of what patients prefer in this scenario.  Are they satisfied with receiving verbal instructions alone, or would they prefer a physical handout to be able to refer to after their consult is complete?


Research Students and Staff

Christine Lee

Summer Research Student - 2016, 2017

Research Project:

Survey of the Knowledge and Attitudes of Saskatchewan's Community Healthcare Workers Towards Antimicrobial Stewardship (2016)

Effect of an Educational Intervention on Reducing the Use of Urine Cultures and Antibiotic Treatment of Asymptomatic Bacteriuria in Long Term Care (2017)

Other Projects: Antimicrobial Stewardship Program website development, informational tool development for community clinics.


Shelby Pflanzner

Summer Research Student - 2017

Research Project: ICU are on Antibiotics: Antimicrobial Stewardship in Intensive Care [Cosupervised by Dr. Jonathan Mailman (PharmD), Clinical Pharmacy Specialist (Critical Care)]

Maryam Jafari, MPH

Research Assistant

Research Project: Evaluation of Antimicrobial Stewardship Community Interventions in the Regina Qu'Appelle Health Region

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