Author and year of publication | Site of evaluation | Strategy | Type of control | Main results |
---|---|---|---|---|
Agwu et al., 2008 [36] | Single hospital | World Wide Web-based antimicrobial restriction program, automated clinical decision support, facilitated approval, enhanced real-time communication among prescribers, pharmacists, and paediatric infectious disease fellows | Before and after implementation of the program, evaluation of user satisfaction, reports of missed and/or delayed doses, antimicrobial dispensing times and costs | Satisfaction increased from 22–68 % and from 13–69 % among prescribers and pharmacists, respectively. Reductions of 21 % and 32 % in the number of missed and delayed antimicrobial doses, respectively $370,069 reduction in projected annual costs |
Metjian et al., 2008 [37] | Single hospital | Evaluation of outcomes and compliance resulting from empirical antibiotic therapy decisions | Intervention to modify antibiotic therapy | 45Â % of prescriptions required an intervention. |
Di Pentima et al., 2011 [38] | Single hospital | Antimicrobial use indications were included as a mandatory field in the computerized information system | Prescriptions were reviewed by specialists | Reduction in antimicrobials of more than 30Â % for both targeted and nontargeted drugs |
Hersh et al., 2015 [39] | Nine hospitals | Antimicrobial consumption after introduction of an antimicrobial stewardship program defined as a program able to continuously monitor use with the support of a dedicated team in some hospitals | Evaluation of days of therapy per 1,000 patient-days | Decline in average antibiotic use in hospitals with antimicrobial stewardship program of 11Â % vs 8Â % in those without the program |
Filkelstein et al., 2008 [40] | The community (16 non-overlapping communities) | Guideline dissemination, small-group education, frequent updates, education material for paediatricians and parents | Consumption of antibiotics | The intervention had no effect among children aged 3–23 months but was associated with a 4 % and 7 % decrease in antibiotic prescriptions in those aged 24–47 months and 48–71 months, respectively. |
Gerber et al., 2013 [41] | The community (162 clinicians) | One 1-h on-site education session followed by one year of personalized quarterly audits and feedback on prescriptions for respiratory infections or usual practice in a group of enrolled individuals | Consumption of antibiotics | Broad spectrum antibiotic prescriptions decreased from 27Â % to 14Â % among intervention practices and from 28Â % to 23Â % in controls. Off-guideline prescriptions decreased from 16Â % to 4Â % among intervention practices compared with a decrease from 17Â % to 16Â % in controls. |