Antimicrobial Stewardship Programmes in Brazil: introductory analysis




Antimicrobial resistance; Stewardship; Antimicrobial.


Introduction: Antimicrobial Stewardship Program (ASP) aims to reeducate the use of antimicrobials. Objective: To manage and evaluate the implementation of ASP in an Adult Intensive Care Unit in Brazilian hospitals. Method: Prospective cross-sectional study, reporting introductory data and factors that advised and helped to implement the ASP in 954 (55.6%) hospitals, corresponding to 25,565 beds, from all 27 Brazilian states.Results: Of the 954 hospitals, 453 (47.5%) have ASP, with the most regular factors being: 369 (81.5%) top management support; 343 (75.7%) availability of clinical protocols; 276 (60.9%) support and adherence by doctors and 259 (57.2%) official definition of the management team. The most difficult causes were: 202 (44.6%) operational team without defined or insufficient time; 134 (29.6%) lack of information technology support; 173 (38.2%) resistance or opposition from doctors and 116 (25.6%) lack of commitment from the teams. Conclusion: the implementation of ASP is an executable proposal for the optimization and rational use in the management of antimicrobials. In Brazil, this proposal will collaborate for direct actions in ICUs, guided by the government, with a relevant impact on the control of antimicrobial resistance. In Brazil, this proposal will contribute to direct actions in ICUs, guided by the government, with a relevant impact on the control of antimicrobial resistance. Brazil needs to improve all elements, with education and definition of responsibilities and professionals.


Alghamdi, S., Atef-Shebl, N., Aslanpour, Z. & Berrou, I. (2019). Barriers to implementing antimicrobial stewardship programmes in three Saudi hospitals: Evidence from a qualitative study. Journal of global antimicrobial resistance. 18: 284-290.

Almulhim, A.S., Aldayyen, A., Yenina, K., Chiappini, A., & Khan, T. M. (2019). Optimization of antibiotic selection in the emergency department for urine culture follow ups, a retrospective pre-post intervention study: clinical pharmacist efforts. Journal of pharmaceutical policy and practice. 12: 1-7.

ANVISA. (2019). Programa nacional de prevenção e controle de infecções relacionadas à assistência à saúde (2016-2020).

ANVISA. (2018). Diretriz Nacional para Elaboração de Programa de Gerenciamento do Uso de Antimicrobianos em Serviços de Saúde.

ANVISA. (2019). Projeto Stewardship Brasil. Avaliação Nacional dos Programas de Gerenciamento do Uso de Antimicrobianos em Unidade de Terapia Intensiva Adulto dos Hospitais Brasileiros.

Balkhy, H. H., El-Saed, A., El-Metwally, A., Arabi, Y. M., Aljohany, S. M., Zaibag, M. A. et al. (2018). Antimicrobial consumption in five adult intensive care units: a 33-month surveillance study. Antimicrobial Resistance & Infection Control. 7(156): 1-9.

Benić, M. S., Milanič, R., Monnier, A. A., Gyssens, I. C., Adriaenssens, N., Versporten, A. et al. (2018). Metrics for quantifying antibiotic use in the hospital setting: results from a systematic review and international multidisciplinary consensus procedure. Journal of Antimicrobial Chemotherapy. 73(6): 50-58.

Black, E. K., MacDonald, L., Neville, H. L., Abbass, K., Slayter, K., Johnston, L. et al. (2019). Health care providers’ perceptions of antimicrobial use and stewardship at acute care hospitals in Nova Scotia. The Canadian journal of hospital pharmacy. 72(4): 263-270.

Chambers, A., MacFarlane, S., Zvonar, R., Evans, G., Moore, J. E., Langford, B. J., Augustin, A. et al. (2019). A recipe for antimicrobial stewardship success: Using intervention mapping to develop a program to reduce antibiotic overuse in long-term care. Infect Control Hosp Epidemiol. 40(1): 24-31.

Charani, E., Smith, I., Skodvin, B., Perozziello, A., Lucet, J., Lescure, F. et al. (2019). Investigating the cultural and contextual determinants of antimicrobial stewardship programmes across low-, middle-and high-income countries—A qualitative study. PLoS One. 14(1): 1-20.

Conway, E. L., Sellick, J. A., Horey, A., Fodero. K., Ottet, M. C. et al. (2017). Decreased mortality in patients prescribed vancomycin after implementation of antimicrobial stewardship program. American journal of infection control. 45(11): 1194-1197.

Gebretekle, G. B., Mariam, D. H., Abebe, W., Amogne, W., Tenna, A., Fenta, T. G. et al. (2018). Opportunities and barriers to implementing antibiotic stewardship in low and middle-income countries: lessons from a mixed-methods study in a tertiary care hospital in Ethiopia. PLoS One. 13(12): 1-15.

Hawes, L., Buising, K. & Mazza, D. (2020). Antimicrobial Stewardship in General Practice: A Scoping Review of the Component Parts. Antibiotics. 9(8):498.óticos9080498.

Heo, M., Kim, N. & Faith, M. S. (2015). Statistical power as a function of Cronbach alpha of instrument questionnaire items. BMC Medical Research Methodology. 15(86): 1-9.

Luther, V. P., Shnekendorf, R., Abbo, L. M., Advani, S., Armstrong, W. S., Barsoumian, A. E. et al. (2018). Antimicrobial stewardship training for infectious diseases fellows: program directors identify a curriculum need. Clinical Infectious Diseases. 67(8): 1285-1287.

McCarthy, M. W. & Walsh, T. J. (2018). The rise of hospitalists: an opportunity for infectious diseases investigators. Expert review of anti-infective therapy. 16(5): 385-389.

Pitiriga, V., Kanellopoulos, P., Kampos, E., Panagiotakopoulos, G., Tsakris, A. & Saroglou, G. (2018). Antimicrobial stewardship program in a Greek hospital: implementing a mandatory prescription form and prospective audits. Future microbiology. 13(8): 889-896.

Pulcini, C., Binda, F., Lamkang, A. S., Trett, A., Charani, E., Goff, D. A. et al. (2019). Developing core elements and checklist items for global hospital antimicrobial stewardship programmes: a consensus approach. Clinical Microbiology and Infection. 25: 20-25.

Quirós, R., Angeleri, P., Zurita, J., Aleman, W., Carneiro, M. & Guerra, S. (2020). Impact of Antimicrobial Stewardship Programs in Latin American Adult Intensive Care Units: PROA-LATAM Project. Infection Control & Hospital Epidemiology. 41(S1): s520-s520.

Saha, S. K., Kong, D. C. M., Thursky, K. & Mazza, D. (2020). A Nationwide Survey of Australian General Practitioners on Antimicrobial Stewardship: Awareness, Uptake, Collaboration with Pharmacists and Improvement Strategies. Antibiotics. 9(6):1–13.óticos9060310.

Wang, S., Pulcini, C., Rabaud, C., Boivin, J. M. & Birgé, J. (2015). Inventory of antibiotic stewardship programs in general practice in France and abroad. Medecine et maladies infectieuses. 45(4): 111-123.




How to Cite

MENEZES, R. M.; GONÇALVES, M. R. S. .; COSTA, M. M. de M.; KRUMENNAUER, E. C. .; CARNEIRO, G. M. .; REUTER, C. P.; RENNER, J. D. P. .; CARNEIRO, M. Antimicrobial Stewardship Programmes in Brazil: introductory analysis. Research, Society and Development, [S. l.], v. 11, n. 7, p. e51011729444, 2022. DOI: 10.33448/rsd-v11i7.29444. Disponível em: Acesso em: 6 jul. 2022.



Health Sciences