MUHC ASP Annual report 2025-2026

We are pleased to release the MUHC annual report for 2025-2026. It is available on the <<Resources>> page of the website. Below is a brief summary highlighting the key points and challenges of 2025-2026.

Highlights

•Four new or updated institutional guidelines published (ESBL/AmpC/CRE, urethritis/prostatitis/epididymo-orchitis, CDI update, automatic IV-to-PO conversion protocol).

•Development of an Antibiotic guide with MUHC-specific AWaRe classification to support clinicians’ prescribing decisions; available online

•Ceftobiprole added to the MUHC formulary; ceftazidime/avibactam, meropenem/vaborbactam, and imipenem/relebactam newly stocked.

•Internal medicine services at both MGH and RVH showing gains in prescribing quality and adherence to ASP recommendations

•Website engagement grew, with unique visitors up 15.1% year-over-year

•Sustained decrease in antimicrobial use across the RVH and MGH sites, particularly for broad-spectrum antibiotics – observed shift towards use of narrower agents, consistent with program objectives

Challenges

•Continued rise in community-acquired MRSA prevalence at RVH and MGH (S. aureus oxacillin susceptibility down 8–10% since 2020–2021 at both sites).

•Declining Klebsiella spp and E. coli susceptibility to third-generation cephalosporins possibly reflecting increasing ESBL prevalence.

•Prescribing appropriateness remains low in surgical services and warrants continued prospective audits with immediate feedback targeting those units.

•Antimicrobial use continues to increase at the MNI, where we currently have no stewardship activities

•Rising costs for several last-line agents, though volume of use remains low and restricted to ID .

•Increase in APSS alerts rejected by pharmacists (23.8%→32.8%), which may reflect alert fatigue or an alert-calibration issue worth investigating with the informatics team.

Cheers

Francois Bourdeau, co-chair MUHC ASP