Advancing antimicrobial stewardship: Summary of the 2015 CIDSC Report
Bibliographic record
Abstract
Background: Antimicrobial resistance (AMR) is recognized as an important global public health concern that has a cross-cutting impact on human health, animal health, food and agriculture and the environment.The Communicable and Infectious Disease Steering Committee (CIDSC) of the Pan-Canadian Public Health Network (PHN) created a Task Group on Antimicrobial Stewardship to look at this issue from a Canadian perspective.Objective: To summarize the key findings of the Task Group Report that identified core components of antimicrobial stewardship programs, best practices, key challenges, gaps and recommendations to advance stewardship across jurisdictions.Methods: Search strategies were developed to identify scientific literature, grey literature and relevant websites on antimicrobial stewardship.The information was reviewed, and based on this evidence, expert opinion and consensus-building, the Task Group identified core components, best practices, key challenges and gaps and developed recommendations to advance stewardship in Canada.Results: The four components of a promising antimicrobial stewardship initiative were: leadership, interventions, monitoring/evaluation and future research.Best practices include a multi-sectoral/multipronged approach involving a wide range of stakeholders at the national, provincial/territorial, local and health care organizational levels.Key challenges and gaps identified were: the success and sustainability of stewardship undertakings require appropriate and sustained resourcing and expertise; there is limited evidence about how to effectively implement treatment guidance; and there is a challenge in ensuring accessibility, standardization and consistency of use among professionals.Recommendations to the CIDSC about how to advance stewardship across jurisdictions included the following: institute a national infrastructure; develop best practices to implement stewardship programs; develop education and promote awareness; establish consistent evidence-based guidance, resources, tools and training; mandate the incorporation of stewardship education; develop audit and feedback tools; establish benchmarks and performance targets for stewardship; and conduct timely evaluation of stewardship programs.Conclusion: Findings of this report will inform a more systematic approach to addressing antimicrobial stewardship Canada-wide.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.060 | 0.080 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.003 |
| Bibliometrics | 0.018 | 0.020 |
| Science and technology studies | 0.004 | 0.002 |
| Scholarly communication | 0.009 | 0.003 |
| Open science | 0.005 | 0.006 |
| Research integrity | 0.003 | 0.005 |
| Insufficient payload (model declined to judge) | 0.007 | 0.003 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".