BACKGROUND Infections result from invasions of an organism into body tissues leading to diseases and complications that might eventually lead to death. Inappropriate use of antimicrobials has led to development of antimicrobial resistance (AMR) which has been associated with increased mortality, morbidity and health costs. Antimicrobial stewardship (AMS) programs are designed to ensure appropriate selections of an effective antimicrobial drugs and optimizing antibiotic use to minimize antibiotic resistance by implementing certain policies, strategies and guidelines. The aim of this study was to investigate practitioners' perceptions regarding AMS implementation and to identify challenges and facilitators of these programs execution. METHODS Cross-sectional study among health care providers in Eastern province of Saudi Arabia Hospitals. The data was collected using a survey including questions about demographic data and information about clinicians' (physicians, pharmacists and nurses) previous experience with AMS and prescribing of antibiotics, the level of knowledge and attitudes regarding AMS programs' implementation. RESULTS More than 50% of clinicians (N = 184) reported lack of awareness of AMS programs and their components, whereas 71.2% do not have previous AMS experience. The majority of clinicians (72.3%) noticed increasing number of AMR infections over the past 5 years and (69.6%) were involved in care of patients with an antibiotic-resistant infection. Around 77.2% of respondents reported that formulary management can be helpful for AMS practice and majority of respondents (79.9%) reported that the availability of pathogens and antimicrobial susceptibility testing can be helpful for AMS. Major barriers to AMS implementation identified were lack of internal policy/guidelines and specialized AMS information resources. Lack of administrative awareness about AMS programs; lack of personnel, time limitation, limited training opportunities, lack of confidence, financial issue or limited funding and lack of specialized AMS information resources were also reported 65.8%, 62.5%, 60.9%, 73.9%, 50%, 54.3 and 74.5%, respectively. CONCLUSION Our study identified comprehensive education and training needs for health care providers about AMS programs. Furthermore, it appears that internal policy and guidelines need revision to ensure that the health care providers work consistently with AMS. Future research must focus on the benefit of implementing AMS as many hospitals are not implementing AMS as revealed by the clinicians. We recommend policy makers and concerned health authorities to consider the study findings into account to optimize AMS implementation.

中文翻译：

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卫生保健提供者对抗菌药物管理计划 (AMS) 实施促进因素和挑战的看法：沙特阿拉伯东部省的一项横断面研究。

背景技术感染是由生物体侵入身体组织引起的，导致疾病和并发症，最终可能导致死亡。抗菌药物的不当使用导致了抗菌药物耐药性（AMR）的产生，这与死亡率、发病率和健康成本的增加有关。抗菌药物管理 (AMS) 计划旨在确保适当选择有效的抗菌药物并优化抗生素使用，通过实施某些政策、策略和指南来最大限度地减少抗生素耐药性。本研究的目的是调查从业者对 AMS 实施的看法，并确定这些计划执行的挑战和促进因素。方法 对沙特阿拉伯东部省份医院的医疗保健提供者进行横断面研究。数据是通过一项调查收集的，其中包括有关人口统计数据的问题以及有关临床医生（医生、药剂师和护士）以前使用 AMS 和抗生素处方的经验、对 AMS 计划实施的知识水平和态度的信息。结果 超过 50% 的临床医生 (N = 184) 表示缺乏对 AMS 计划及其组成部分的认识，而 71.2% 的人以前没有 AMS 经验。大多数临床医生 (72.3%) 注意到过去 5 年来 AMR 感染数量不断增加，并且 (69.6%) 参与了抗生素耐药感染患者的护理。约 77.2% 的受访者表示，处方管理有助于 AMS 实践，大多数受访者 (79.9%) 表示，病原体和抗菌药物敏感性测试的可用性有助于 AMS。确定的 AMS 实施的主要障碍是缺乏内部政策/指南和专门的 AMS 信息资源。缺乏对 AMS 计划的管理意识；还报告称缺乏人员、时间限制、培训机会有限、缺乏信心、财务问题或资金有限以及缺乏专门的 AMS 信息资源 65.8%、62.5%、60.9%、73.9%、50%、54.3 和 74.5%，分别。结论 我们的研究确定了医疗保健提供者对 AMS 计划的全面教育和培训需求。此外，内部政策和指南似乎需要修订，以确保医疗保健提供者与 AMS 保持一致。未来的研究必须重点关注实施 AMS 的好处，因为临床医生透露，许多医院并未实施 AMS。我们建议政策制定者和相关卫生当局考虑研究结果，以优化 AMS 实施。