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

Abstract Background 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) Methods 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. Results 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). Conclusion 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. Disclosures 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